Gary F Alsofrom, MD

Primary specialty

Neuroradiology PhysicianTaxonomy code 2085N0700X

License

042-0007582 Issued in VT

Practice address

111 Colchester Ave
Dept. of Radiology
Burlington, VT 05401-1473

Phone

(802) 847-3592

Fax

(802) 847-4822

NPI assigned

Jul 21, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• PT 360 Inc

  • Physical Therapist
  • Williston, VT
  • NPI 1609183177
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154342913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 SUMMIT ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054013931",
            "telephone_number": "802-847-3592",
            "fax_number": "802-847-4822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "address_2": "DEPT. OF RADIOLOGY",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-3592",
            "fax_number": "802-847-4822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALSOFROM",
        "first_name": "GARY",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "VT",
            "license": "042-0007582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9557",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Allosso, LCMHC
• Kimberly Allshouse, MSW,MA,LP
• Joseph Aloi, PHARM.D.
• Jamie Alpert, M.D.
• Alpine Telehealth, PC
• Wallace Kemper Alston, MD
• Astin Altenburg
• Erin Altermatt, LCMHC
• Robert R Althoff, MD PHD
• Alexandra Altman

• Neuroradiology Physician in Burlington, VT
• Providers in Burlington, VT by specialty
• Neuroradiology Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.