Leah Mariette Macaulay, P.N.P
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · South Burlington, VT
NPI 1124357215 · NPPES record last updated May 20, 2025
Key facts
- NPI
- 1124357215
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 101.0060740 (VT)
- Practice address
- 595 Dorset St Ste 4
South Burlington, VT 05403-6240 - Phone
- (802) 489-5552
- NPI assigned
- Dec 18, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181015002574 | VT | Practitioner - Nurse Practitioner | 0446502710 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101.0060740 | VT | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Primary Care Health Partners - New York LLP | Current |
Accepting new patients | |
| Primary Care Health Partners - Vermont LLP | Psychiatric/Mental Health | Current |
Accepting new patients |
| Primary Care Health Partners | Past | Accepting new patients |
Locations
1127 North Ave
Ste 1
Burlington, VT 05408
Phone (802) 846-8100
51 Timber Ln
South Burlington, VT 05403
Phone (802) 864-0521
595 Dorset St
Ste 4
South Burlington, VT 05403
Phone (802) 343-0901
600 Blair Park Rd
Ste 285
Williston, VT 05495
Phone (802) 288-1140
66 Knight Ln
Ste 10
Williston, VT 05495
Phone (802) 872-4327
Interoperability endpoints
- lmacaulay@pchpmd.medentdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 101.0060740 | VT | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 101.0060740 | VT | Yes |
Addresses
Primary practice location
595 Dorset St Ste 4
South Burlington, VT 05403-6240
Mailing address
600 Blair Park Rd Ste 285
Williston, VT 05495-7586
Phone (802) 288-1140
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1019167 | Medicaid | VT |
Other names
- Leah Mariette Porter
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lmacaulay@pchpmd.medentdirect.com | Direct |
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All providers in South Burlington, VT · Psychiatric/Mental Health Nurse Practitioner in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.