Samuel Weiss, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089-0125268 Issued in VT

Practice address

1138 Pine St
Burlington, VT 05401-5353

Phone

(802) 488-6600

Fax

(802) 488-6919

NPI assigned

Oct 6, 2017

Last updated

Oct 6, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• University of Vermont Medical Center Inc

  dba Uvm Medical Center

  • Internal Medicine Physician
  • Burlington, VT
  • NPI 1659309615
  Medicare reassignment

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

{
    "created_epoch": "1507248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507248000000",
    "number": "1093225831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 FLYNN AVE STE 3J",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015420",
            "telephone_number": "802-488-6920",
            "fax_number": "802-488-6919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 PINE ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015353",
            "telephone_number": "802-488-6600",
            "fax_number": "802-488-6919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "SAMUEL",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-06",
        "last_updated": "2017-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089-0125268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Weintraub, M.D.
• Daniel Johannes Weise, APRN
• Wolfgang Johannes Weise, M.D.
• Caroline Rose Weisheit, AGNP-C
• Daniel J Weiss, MD PHD
• Alexander Clemens Weissman, MD
• Deborah Weizenegger
• Julie Ann Welkowitz, PH.D.
• Wellnite Medical Group PA
• Elisabeth B Wells, NP

• Clinical Social Worker in Burlington, VT
• Providers in Burlington, VT by specialty
• Clinical Social Worker in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2017; 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.

Verify at the official NPI Registry.