Active NPI
Agnes Mikijaniec, ARNP
- Acute Care Nurse Practitioner
- Brattleboro, VT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 026-0029155
- Practice address
- 17 Belmont Ave
Att'N: Marilyn Boudreau
Brattleboro, VT 05301-6613 - Phone
- (802) 257-8382
- Fax
- (802) 251-8466
- NPI assigned
- Jun 25, 2006
- 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 |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 026-0029155 | VT | Primary |
Addresses
Primary practice location
17 Belmont Ave
Att'N: Marilyn Boudreau
Brattleboro, VT 05301-6613
Mailing address
17 Belmont Ave
Att'N: Marilyn Boudreau
Brattleboro, VT 05301-6613
Phone (802) 257-8382
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ONP3598 | Medicaid | VT | |
| 68614 | Other | VT | BLUE SHIELD OF VT |
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
19 Belmont Ave
Suite 1202
Brattleboro, VT 05301-4004
Phone (802) 251-8650
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 026-0029155 | VT | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brattleboro Memorial Hospital | Current | Accepting new patients | |
| Southern Vermont Health Services Corp | Past | Accepting new patients |
Locations
19 Belmont Ave
Ste 1202
Brattleboro, VT 05301
Phone (802) 251-8650
17 Belmont Ave
Brattleboro, VT 05301
Phone (802) 257-8360
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/d9dc001d-1bc5-42f9-bd4d-eb79208fd32a/
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
- Brattleboro, VT
- NPI 1306849708
-
- General Practice Physician
- Brattleboro, VT
- NPI 1952319220
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Brattleboro, VT
- NPI 1306849708
-
dba Grace Cottage Hospital
- Critical Access Hospital
- Townshend, VT
- NPI 1255337473
-
- General Acute Care Hospital
- Keene, NH
- NPI 1629181516
-
- General Acute Care Hospital
- Lebanon, NH
- NPI 1023092053
-
dba MHMH Regional Services
- General Acute Care Hospital
- Lebanon, NH
- NPI 1629788237
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1093741571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 BELMONT AVE",
"address_2": "ATT'N: MARILYN BOUDREAU",
"city": "BRATTLEBORO",
"state": "VT",
"postal_code": "053016613",
"telephone_number": "802-257-8382",
"fax_number": "802-251-8466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 BELMONT AVE",
"address_2": "ATT'N: MARILYN BOUDREAU",
"city": "BRATTLEBORO",
"state": "VT",
"postal_code": "053016613",
"telephone_number": "802-257-8382",
"fax_number": "802-251-8466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIKIJANIEC",
"first_name": "AGNES",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-25",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "VT",
"license": "026-0029155",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ONP3598",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF VT",
"identifier": "68614",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brattleboro, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.