Active NPI
Aaron Michael Wallace, MD
- Pediatrics Physician
- Barre, VT
National Provider Identifier
1073037016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD23914
- Practice address
- 246 Granger Rd Ste 1
Barre, VT 05641-5352 - Phone
- (802) 371-5950
- NPI assigned
- Aug 1, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD23914 | ME | Primary |
Addresses
Primary practice location
246 Granger Rd Ste 1
Barre, VT 05641-5352
Mailing address
17 Wingate Dr
Portland, ME 04102-1829
Phone (860) 214-6273
Other practice location 1
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-2911
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Vermont Medical Center Inc | Pediatrics | Current | Accepting new patients |
| Central Vermont Medical Center Inc | Past | Accepting new patients |
Locations
246 Granger Rd
Ste 1
Barre, VT 05641
Phone (802) 371-5950
130 Fisher Rd
#C
Berlin, VT 05602
Phone (802) 225-5400
Interoperability endpoints
- awallace593353@direct.uvmhealth.org
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.
-
- General Acute Care Hospital
- Berlin, VT
- NPI 1508845637
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1073037016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 WINGATE DR",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041021829",
"telephone_number": "860-214-6273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "246 GRANGER RD STE 1",
"city": "BARRE",
"state": "VT",
"postal_code": "056415352",
"telephone_number": "802-371-5950"
}
],
"practiceLocations": [
{
"address_1": "22 Bramhall St",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "ME",
"postal_code": "041023134",
"country_code": "US",
"telephone_number": "207-662-2911",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALLACE",
"first_name": "AARON",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-08-01",
"last_updated": "2025-09-11",
"certification_date": "2024-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "ME",
"license": "MD23914",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Barre, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.