Individual provider Active NPI

William S Grass, MD

  • Psychiatry Physician
  • Burlington, VT
National Provider Identifier
1124041348
Registry record updated Jul 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
042-0009917 Issued in VT
Practice address
118 Pine St
Burlington, VT 05401-8421
Phone
(802) 660-8000
Fax
(802) 862-4062
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 042-0009917 VT Primary

Addresses

Primary practice location

118 Pine St
Burlington, VT 05401-8421

Mailing address

118 Pine St
Burlington, VT 05401-8421
Phone (802) 660-8000

Other identifiers 2

IdentifierTypeStateIssuer
1007917MedicaidVT
30201707MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042-0009917VTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
C. Emma Burrous, PH.D., PLC Past Accepting new patients
Springfield Hospital Inc Psychiatry Past Accepting new patients
Maple Leaf Farm Associates, Inc. Past Accepting new patients

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372636800000",
    "number": "1124041348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 PINE ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054018421",
            "telephone_number": "802-660-8000",
            "fax_number": "802-862-4062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 PINE ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054018421",
            "telephone_number": "802-660-8000",
            "fax_number": "802-862-4062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRASS",
        "first_name": "WILLIAM",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2013-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VT",
            "license": "042-0009917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007917",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30201707",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.