Active NPI
Matrix Health Systems P.C.
- Clinical Psychologist
- Burlington, VT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- Legal business name
- MATRIX HEALTH SYSTEMS P.C.
- Practice address
- 86 Lake St
Burlington, VT 05401-5297 - Phone
- (802) 865-3450
- Fax
- (802) 860-5011
- NPI assigned
- May 25, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. David Fassler, M.D.
- Title
- Clinical Director
- Phone
- (802) 865-3450
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | Primary |
Addresses
Primary practice location
86 Lake St
Burlington, VT 05401-5297
Mailing address
86 Lake St
Burlington, VT 05401-5297
Phone (802) 865-3450
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OVN1732 | Medicaid | VT | |
| 02112352 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031230000156 | VT | Part B Supplier - Clinic/Group Practice | 1052219359 |
Receives reassigned benefits from 37 practitioners Practice locations: Shelburne, VT; Winooski, VT; South Burlington, VT; Burlington, VT; Brattleboro, VT; Essex JCT, VT |
National Provider Directory
National Provider Directory- Tax ID family
- Crossroads
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Mental Health Counselor
- Essex Junction, VT
- NPI 1427109719
Locations
16 Flynn Ave
Plattsburgh, NY 12901
Phone (518) 563-0950
49 Village Sq
Bellows Falls, VT 05101
Phone (603) 313-5186
49 The Sq
Bellows Falls, VT 05101
Phone (603) 209-6100
80 Linden St
Brattleboro, VT 05301
Phone (802) 254-2291
70 S Winooski Ave
Ste 2B
Burlington, VT 05401
Phone (802) 377-7810
55 Main St
Ste 4
Essex Junction, VT 05452
Phone (802) 879-1802
47 Court St
Middlebury, VT 05753
Phone (802) 377-9448
79 Court St
Middlebury, VT 05753
Phone (802) 353-6580
11 Beaver Meadow Rd
#4
Norwich, VT 05055
Phone (802) 649-2260
359 Dorset St
South Burlington, VT 05403
Phone (802) 310-3992
15 Palmer Rd
Stowe, VT 05672
Phone (802) 760-6185
486 Main St
Winooski, VT 05404
Practitioners & affiliated clinicians
Practitioners 89
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Addiction (Substance Use Disorder) Counselor
- South Burlington, VT
- NPI 1740663665
VT
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1416528000000",
"number": "1104872712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "86 LAKE ST",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054015297",
"telephone_number": "802-865-3450",
"fax_number": "802-860-5011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "86 LAKE ST",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054015297",
"telephone_number": "802-865-3450",
"fax_number": "802-860-5011"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MATRIX HEALTH SYSTEMS P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-25",
"last_updated": "2014-11-21",
"status": "A",
"authorized_official_last_name": "FASSLER",
"authorized_official_first_name": "DAVID",
"authorized_official_title_or_position": "CLINICAL DIRECTOR",
"authorized_official_telephone_number": "802-865-3450",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "OVN1732",
"state": "VT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02112352",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.