NPIMap

Individual provider Active NPI

Robert A Luebbers, M.D.

  • Family Medicine Physician
  • South Burlington, VT
National Provider Identifier
1124042627
Registry record updated Jan 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
420008825 Issued in VT
Practice address
1775 Williston Rd
South Burlington, VT 05403-6491
Phone
(802) 847-8500
Fax
(802) 847-6140
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 420008825 VT Primary

Addresses

Primary practice location

1775 Williston Rd
South Burlington, VT 05403-6491

Mailing address

1775 Williston Rd
South Burlington, VT 05403-6491
Phone (802) 847-8500

Other identifiers 2

IdentifierTypeStateIssuer
01785280MedicaidNY
OVN0671MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060403000604 VT Practitioner - Family Practice 6204844210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Geisel School of Medicine at Dartmouth, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 S Prospect St
Burlington, VT 05401-3456
Phone (802) 847-0000

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
420008825VTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc Family Medicine CurrentSince Jul 1, 1993 Accepting new patients
GM Operations LLC Past Accepting new patients
Fletcher Allen Health Care Inc Past Accepting new patients

Locations

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

1775 Williston Rd
South Burlington, VT 05403
Phone (802) 847-2391

3 Timber Ln
South Burlington, VT 05403
Phone (802) 847-3339

Interoperability endpoints

  • Direct secure messaging: rluebbers3872@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.

Hospital & facility affiliations 25

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262995200000",
    "number": "1124042627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 WILLISTON RD",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036491",
            "telephone_number": "802-847-8500",
            "fax_number": "802-847-6140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 WILLISTON RD",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036491",
            "telephone_number": "802-847-8500",
            "fax_number": "802-847-6140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUEBBERS",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2010-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "420008825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01785280",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN0671",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Burlington, VT

Sources for this page

Verify at the official NPI Registry.