Individual provider Active NPI

Mohammad Basil Amin, M.D

  • Internal Medicine Physician
  • Berlin, VT
National Provider Identifier
1104881101
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
042.0014077 Issued in VT
Practice address
142 Woodridge Rd
Berlin, VT 05602-9165
Phone
(802) 371-4700
NPI assigned
Apr 20, 2006
Last updated
May 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Internal Medicine) Physician 207RA0401X ME0072588 FL
Internal Medicine Physician 207R00000X 042.0014077 VT Primary

Addresses

Primary practice location

142 Woodridge Rd
Berlin, VT 05602-9165

Mailing address

PO Box 2468
Palatka, FL 32177
Phone (386) 325-8482

Other practice location 1

205 Zeagler Dr.
Suite # 401-B
Palatka, FL 32177
Phone (386) 325-8482

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, VT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220825003657 NY Practitioner - Internal MedicinePractitioner - Addiction Medicine 3375441108 Reassigns benefits to 1 organization
I20241226002024 VT Practitioner - Internal Medicine 3375441108 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0072588FLMDAddiction Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
River Hospital, Inc. CurrentSince Jun 1, 2022 Accepting new patients
Central Vermont Medical Center Inc Internal Medicine CurrentSince Nov 6, 2024 Accepting new patients
River Hospital, Inc. CurrentSince Jun 1, 2022 Accepting new patients

Locations

4 Fuller St
Alexandria Bay, NY 13607
Phone (315) 482-1277

130 Fisher Rd
#C
Berlin, VT 05602
Phone (802) 225-5400

142 Woodridge Rd
Berlin, VT 05602
Phone (802) 371-4700

Interoperability endpoints

  • Direct secure messaging: mamin593570@direct.uvmhealth.org

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, 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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1104881101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2468",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "32177",
            "telephone_number": "386-325-8482",
            "fax_number": "386-325-3512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 WOODRIDGE RD",
            "city": "BERLIN",
            "state": "VT",
            "postal_code": "056029165",
            "telephone_number": "802-371-4700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 ZEAGLER DR.",
            "address_2": "SUITE # 401-B",
            "address_purpose": "LOCATION",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "32177",
            "country_code": "US",
            "telephone_number": "386-325-8482",
            "fax_number": "386-325-3512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMIN",
        "first_name": "MOHAMMAD",
        "middle_name": "BASIL",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "FL",
            "license": "ME0072588",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VT",
            "license": "042.0014077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, VT

Sources for this page

Verify at the official NPI Registry.