Active NPI
Luiz Mauricio Kolankiewicz, M.D.
- Nephrology Physician
- White River Junction, VT
National Provider Identifier
1043529506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 262974
- Practice address
- 215 N Main St
White River Junction, VT 05009-1538 - Phone
- (802) 295-9363
- NPI assigned
- Oct 1, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 262974 | NY | Primary |
| Nephrology Physician | 207RN0300X | 23096 | NH | |
| Nephrology Physician | 207RN0300X | 0101248493 | VA | |
| Nephrology Physician | 207RN0300X | MD13489 | RI |
Addresses
Primary practice location
215 N Main St
White River Junction, VT 05009-1538
Mailing address
69 Etna Rd Unit 118
Lebanon, NH 03766-2404
Phone (201) 240-7762
Other practice location 1
1287 N Main St Unit X
Providence, RI 02904-1856
Phone (401) 272-2724
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23096 | NH | MD | Nephrology Physician |
| 262974 | NY | MD | Nephrology Physician |
| MD13489 | RI | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peninsula Kidney Associates PC | Nephrology | Past | Accepting new patients |
| Peninsula Vascular Center, P.C. | Nephrology | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Nephrology Physician
- Hampton, VA
- NPI 1750436531
-
- Nephrology Physician
- Hampton, VA
- NPI 1093070781
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784592000000",
"number": "1043529506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "69 ETNA RD UNIT 118",
"city": "LEBANON",
"state": "NH",
"postal_code": "037662404",
"telephone_number": "201-240-7762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 N MAIN ST",
"city": "WHITE RIVER JUNCTION",
"state": "VT",
"postal_code": "050091538",
"telephone_number": "802-295-9363"
}
],
"practiceLocations": [
{
"address_1": "1287 N Main St Unit X",
"address_purpose": "LOCATION",
"city": "Providence",
"state": "RI",
"postal_code": "029041856",
"country_code": "US",
"telephone_number": "401-272-2724",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KOLANKIEWICZ",
"first_name": "LUIZ",
"middle_name": "MAURICIO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-10-01",
"last_updated": "2026-07-21",
"certification_date": "2026-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "NY",
"license": "262974",
"primary": true
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "NH",
"license": "23096",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "VA",
"license": "0101248493",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "RI",
"license": "MD13489",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in White River Junction, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.