Individual provider Active NPI

Daniel E Perregaux, MD

  • Emergency Medicine Physician
  • Bennington, VT
National Provider Identifier
1104846641
Registry record updated Oct 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
042-0010708 Issued in VT
Practice address
100 Hospital Dr
Bennington, VT 05201-5004
Phone
(802) 442-6361
Fax
(802) 447-2469
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 042-0010708 VT Primary

Addresses

Primary practice location

100 Hospital Dr
Bennington, VT 05201-5004

Mailing address

100 Hospital Dr
Bennington, VT 05201-5004
Phone (802) 442-6361

Other identifiers 1

IdentifierTypeStateIssuer
1010408MedicaidVT

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
I20040330001023 VT Practitioner - Emergency Medicine 1557353828 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042-0010708VTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwestern Vermont Medical Center Inc. CurrentSince Jul 1, 2012 Accepting new patients
Southwestern Vermont Medical Center Inc. CurrentSince Jan 22, 2004 Accepting new patients
Southwestern Vermont Medical Center, Inc Past Accepting new patients

Locations

140 Hospital Dr
Ste 116
Bennington, VT 05201
Phone (802) 447-1836

100 Hospital Dr
Bennington, VT 05201
Phone (802) 447-4509

100 Hospital Dr
#44
Bennington, VT 05201
Phone (802) 442-4509

120 Hospital Dr
Bennington, VT 05201
Phone (802) 440-4077

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286928000000",
    "number": "1104846641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DR",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052015004",
            "telephone_number": "802-442-6361",
            "fax_number": "802-447-2469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DR",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052015004",
            "telephone_number": "802-442-6361",
            "fax_number": "802-447-2469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERREGAUX",
        "first_name": "DANIEL",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2010-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VT",
            "license": "042-0010708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010408",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bennington, VT

Sources for this page

Verify at the official NPI Registry.