Individual provider Active NPI

Dorothea S Vongoeler, MD

  • Internal Medicine Physician
  • Leeds, MA
National Provider Identifier
1104834514
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
160687 Issued in MA
Practice address
421 N Main St
Leeds, MA 01053-9764
Phone
(413) 584-4040
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 160687 MA Primary

Addresses

Primary practice location

421 N Main St
Leeds, MA 01053-9764

Mailing address

421 N Main St
Northampton, MA 01060-5300
Phone (413) 584-4040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20250225001699 MA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8426032533

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
160687MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Inpatient Medical Associates Inc. Internal Medicine PastSince Aug 17, 2020 Accepting new patients

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1104834514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 N MAIN ST",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010605300",
            "telephone_number": "413-584-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 N MAIN ST",
            "city": "LEEDS",
            "state": "MA",
            "postal_code": "010539764",
            "telephone_number": "413-584-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONGOELER",
        "first_name": "DOROTHEA",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "160687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leeds, MA

Sources for this page

Verify at the official NPI Registry.