NPIMap

Individual provider Active NPI

Marissa Kate Needleman

  • Surgical Physician Assistant
  • Saint Albans, VT
National Provider Identifier
1104714237
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0550031821 Issued in VT
Practice address
133 Fairfield St
Saint Albans, VT 05478-1726
Phone
(892) 524-1232
NPI assigned
Jun 26, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0550031821 VT Primary

Addresses

Primary practice location

133 Fairfield St
Saint Albans, VT 05478-1726

Mailing address

165 Sheldon Woods Rd
Sheldon, VT 05483-8315
Phone (802) 309-3345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250923000570 VT Practitioner - Physician Assistant 4981109931 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Center Inc 105 clinicians

Practice addresses (Care Compare)

133 Fairfield St
Saint Albans, VT 05478-1726

Hospital & facility affiliations

  • Vna & Hospice of the Southwest Region, Inc. Home health agency, Rutland, VT, CCN 477007
  • Bayada Home Health Care, Inc. Home health agency, Rutland, VT, CCN 477019
  • Northwestern Medical Center Inc Hospital, Saint Albans, VT, CCN 470024
  • Univ. of Vermont - Fletcher Allen Health Care Hospital, Burlington, VT, CCN 470003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0550031821VTMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Center, Inc CurrentSince Sep 4, 2025 Accepting new patients
Northwestern Medical Center Inc CurrentSince Sep 4, 2025 Accepting new patients
Northwestern Medical Center, Inc. Past Accepting new patients

Locations

3 Crest Rd
Saint Albans, VT 05478
Phone (802) 524-4554

133 Fairfield St
Saint Albans, VT 05478
Phone (802) 524-1227

Organizations & group practices 7

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1750896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1104714237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 SHELDON WOODS RD",
            "city": "SHELDON",
            "state": "VT",
            "postal_code": "054838315",
            "telephone_number": "802-309-3345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 FAIRFIELD ST",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054781726",
            "telephone_number": "892-524-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEEDLEMAN",
        "first_name": "MARISSA",
        "middle_name": "KATE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-26",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VT",
            "license": "0550031821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Albans, VT

Sources for this page

Verify at the official NPI Registry.