Individual provider Active NPI

Dorothea L. De Gutis, MD

  • Neurology Physician
  • Brattleboro, VT
National Provider Identifier
1124069588
Registry record updated May 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
042.0012079 Issued in VT
Practice address
51 Fairview St
Brattleboro, VT 05301-6629
Phone
(802) 254-6028
Fax
(802) 254-7501
NPI assigned
Jun 9, 2006
Last updated
May 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 042-0012079 VT
Psychiatry Physician 2084P0800X 042-0012079 VT
Neurology Physician 2084N0400X 042.0012079 VT Primary
Psychiatry Physician 2084P0800X 042.0012079 VT

Addresses

Primary practice location

51 Fairview St
Brattleboro, VT 05301-6629

Mailing address

390 River St
Springfield, VT 05156-2226
Phone (802) 886-4500

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
I20101222000095 VT Practitioner - Psychiatry 6800955261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

390 River St
Springfield, VT 05156-2226
Phone (802) 886-4500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042-0012079VTMDNeurology Physician
042.0012079VTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health Care and Rehabilitation Services of Southeastern Vermont, Inc. CurrentSince Oct 8, 2018 Accepting new patients
Health Care and Rehabilitation Services of Southeastern Vermont, Inc. CurrentSince Oct 8, 2018 Accepting new patients
Brattleboro Retreat Past Accepting new patients

Locations

51 Fairview St
Brattleboro, VT 05301
Phone (802) 254-6028

390 River St
Springfield, VT 05156
Phone (802) 886-4567

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1124069588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 RIVER ST",
            "city": "SPRINGFIELD",
            "state": "VT",
            "postal_code": "051562226",
            "telephone_number": "802-886-4500",
            "fax_number": "802-886-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 FAIRVIEW ST",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053016629",
            "telephone_number": "802-254-6028",
            "fax_number": "802-254-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE GUTIS",
        "first_name": "DOROTHEA",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VT",
            "license": "042-0012079",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VT",
            "license": "042-0012079",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VT",
            "license": "042.0012079",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VT",
            "license": "042.0012079",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brattleboro, VT

Sources for this page

Verify at the official NPI Registry.