Individual provider Active NPI

Phil Allen Aitken, M.D.

  • Ophthalmology Physician
  • South Burlington, VT
National Provider Identifier
1073549945
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
0420005259 Issued in VT
Practice address
55 Timber LN
Suite C
South Burlington, VT 05403-5201
Phone
(802) 652-0717
Fax
(802) 652-0798
NPI assigned
Jun 23, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 0420005259 VT Primary

Addresses

Primary practice location

55 Timber LN
Suite C
South Burlington, VT 05403-5201

Mailing address

55 Timber LN
Suite C
South Burlington, VT 05403-5201
Phone (802) 652-0717

Other identifiers 3

IdentifierTypeStateIssuer
19833OtherBLSH
0004799MedicaidVT
17V300OtherMVP

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061208000320 VT Practitioner - Ophthalmology 7315946910 Reassigns benefits to 1 organization
Practice locations: So Burlington, VT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0420005259VTMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc Ophthalmology CurrentSince Oct 1, 2009 Accepting new patients

Locations

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073549945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 TIMBER LN",
            "address_2": "SUITE C",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054035201",
            "telephone_number": "802-652-0717",
            "fax_number": "802-652-0798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 TIMBER LN",
            "address_2": "SUITE C",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054035201",
            "telephone_number": "802-652-0717",
            "fax_number": "802-652-0798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AITKEN",
        "first_name": "PHIL",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VT",
            "license": "0420005259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLSH",
            "identifier": "19833",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0004799",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "17V300",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Burlington, VT

Sources for this page

Verify at the official NPI Registry.