Organization Active NPI

Maple Run Primary Care PLLC

  • Family Medicine Physician
  • Montpelier, VT
National Provider Identifier
1053288209
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MAPLE RUN PRIMARY CARE PLLC
Practice address
134 Main St
Montpelier, VT 05602-2913
Phone
(802) 341-8775
Fax
(844) 689-3199
NPI assigned
Oct 22, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Brian L Rodriguez, MDNPI 1841587839
Title
Physician/Owner
Phone
(802) 477-2707

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

134 Main St
Montpelier, VT 05602-2913

Mailing address

134 Main St
Montpelier, VT 05602-2913
Phone (802) 341-8775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251111002329 VT Part B Supplier - Clinic/Group Practice 9830680594 Receives reassigned benefits from 1 practitioner
Practice locations: Montpelier, VT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
47D2331242Maple Run Primary Care134 Main St, Montpelier, VT 05602Certificate of waiverSep 28, 2027

National Provider Directory

National Provider Directory

Locations

134 Main St
Montpelier, VT 05602
Phone (802) 341-5555

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1761091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762214400000",
    "number": "1053288209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 MAIN ST",
            "city": "MONTPELIER",
            "state": "VT",
            "postal_code": "056022913",
            "telephone_number": "802-341-8775",
            "fax_number": "844-689-3199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 MAIN ST",
            "city": "MONTPELIER",
            "state": "VT",
            "postal_code": "056022913",
            "telephone_number": "802-341-8775",
            "fax_number": "844-689-3199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE RUN PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-22",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "802-477-2707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montpelier, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.