NPIMap

Individual provider Active NPI

Alexandra Van Dyck, MD

  • Internal Medicine Physician
  • Townshend, VT
National Provider Identifier
1144424979
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
042.0015055 Issued in VT
Practice address
152 Grafton Rd
Townshend, VT 05353
Phone
(603) 667-6272
NPI assigned
Jun 14, 2007
Last updated
Dec 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X RT1758 NH
Internal Medicine Physician 207R00000X 042.0015055 VT Primary

Addresses

Primary practice location

152 Grafton Rd
Townshend, VT 05353

Mailing address

242 Wantastiquet Dr
Brattleboro, VT 05301-6041
Phone (603) 667-6272

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
I20210217000368 VT Practitioner - Internal Medicine 9133389778 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brattleboro Memorial HospitalGroup PAC ID 9335112929, 70 clinicians
Infinite Medical PCGroup PAC ID 8325477656, 87 clinicians

Practice addresses (Care Compare)

21 Belmont Ave
Suite 1
Brattleboro, VT 05301-6762
Phone (802) 251-8455

378 Prospect St
Barre, VT 05641-5421
Phone (718) 534-0689

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.64 of 100Reported as group
Quality
76.13
Improvement activities
40
Cost
69.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RT1758NHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Medical PC CurrentSince Dec 16, 2021 Accepting new patients
Hearth Stone Internal Medicine, LLC Internal Medicine CurrentSince Jan 1, 2021 Accepting new patients
Berlin Operations LLC Past Accepting new patients
Barre Gardens Nursing and Rehab LLC Past Accepting new patients

Locations

250 Skillman St
Ste 202
Brooklyn, NY 11205

378 Prospect St
Barre, VT 05641
Phone (802) 476-4166

Interoperability endpoints

  • Direct secure messaging: alexandra.vandyck@308078203961348.direct.elationemr.com
  • Direct secure messaging: alexandra.vandyck@311083657986052.direct.elationemr.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Barre Gardens Nursing and Rehab LLCBarre, VT, CCN 475037B Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2022
Apr 24, 2025
Berlin Rehab and HealthcareBarre, VT, CCN 475020B Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Dec 18, 2024
Feb 4, 2025

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 10

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": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1144424979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 WANTASTIQUET DR",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053016041",
            "telephone_number": "603-667-6272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 GRAFTON RD",
            "city": "TOWNSHEND",
            "state": "VT",
            "postal_code": "05353",
            "telephone_number": "603-667-6272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DYCK",
        "first_name": "ALEXANDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NH",
            "license": "RT1758",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VT",
            "license": "042.0015055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Townshend, VT

Sources for this page

Verify at the official NPI Registry.