Active NPI
Patricia L Fisher, M.D.
- Family Medicine Physician
- Burlington, VT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 04200106644
- Practice address
- 617 Riverside Ave
Burlington, VT 05401-1601 - Phone
- (802) 864-6309
- Fax
- (802) 860-4324
- NPI assigned
- Dec 16, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 04200106644 | VT | Primary |
Addresses
Primary practice location
617 Riverside Ave
Burlington, VT 05401-1601
Mailing address
900 Dorset St
South Burlington, VT 05403-7502
Phone (802) 864-6309
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 59784 | Other | VT | BLUE CROSS BLUE SHIELD |
| 1010219 | Medicaid | VT | |
| 4661403 | Other | VT | FLETCHER ALLEN PREFERRED |
| 364345 | Other | VT | MVP |
| 59784 | Other | VT | VERMONT MANAGED CARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Texas Medical School at Houston, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Bay Ave
Montclair, NJ 07042-4837
Phone (973) 429-6000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04200106644 | VT | MD | Family Medicine Physician |
Organizations & group practices 1
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.
-
- Emergency Medicine Physician
- Montclair, NJ
- NPI 1134534688
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba JFK University Medical Center
- General Acute Care Hospital
- Edison, NJ
- NPI 1144894577
-
dba Ocean Medical Center
- General Acute Care Hospital
- Brick, NJ
- NPI 1477065126
-
dba Hackensack Meridian Diagnostic Laboratory
- Clinical Medical Laboratory
- Edison, NJ
- NPI 1780301366
Hospital
-
dba Hackensack Meridian Diagnostic Laboratory
- Clinical Medical Laboratory
- Brick, NJ
- NPI 1942927538
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053397570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 DORSET ST",
"city": "SOUTH BURLINGTON",
"state": "VT",
"postal_code": "054037502",
"telephone_number": "802-864-6309",
"fax_number": "802-860-4324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "617 RIVERSIDE AVE",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054011601",
"telephone_number": "802-864-6309",
"fax_number": "802-860-4324"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "PATRICIA",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "VT",
"license": "04200106644",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "59784",
"state": "VT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1010219",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLETCHER ALLEN PREFERRED",
"identifier": "4661403",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "364345",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VERMONT MANAGED CARE",
"identifier": "59784",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.