Mark David Charlson, MD

Primary specialty

Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X

License

42-0011585 Issued in VT

Practice address

192 Tilley Dr
South Burlington, VT 05403-4440

Phone

(802) 847-2663

Fax

(802) 847-3797

NPI assigned

May 18, 2006

Last updated

Sep 25, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Specialty

Orthopedic Surgery

Education

University of North Carolina at Chapel Hill School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

University of Vermont Medical Center IncGroup PAC ID 3779491071, 1,208 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Univ. of Vermont - Fletcher Allen Health Care Hospital, Burlington, VT, CCN 470003
• Northwestern Medical Center Inc Hospital, Saint Albans, VT, CCN 470024
• The University of Vermont Health Network - Champl Hospital, Plattsburgh, NY, CCN 330250

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mcharlson4040@direct.uvmhealth.org

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.

• University of Vermont Medical Center Inc

  dba Uvm Medical Center

  • Internal Medicine Physician
  • Burlington, VT
  • NPI 1659309615
  Medicare reassignment Care Compare group NPD
• Fletcher Allen Health Care Inc

  • Radiation Oncology Physician
  • Burlington, VT
  • NPI 1619266624
  NPD (past)
• Wakemed Faculty Practice Plan

  dba WakeMed Faculty Physicians - Pediatric Hospitalists/Intensivists

  • Pediatric Critical Care Medicine Physician
  • Raleigh, NC
  • NPI 1013203819
  NPD (past)
• Wakemed Faculty Practice Plan

  dba WakeMed Faculty Physicians

  • Surgery Physician
  • Raleigh, NC
  • NPI 1396791786

  Orthopaedic Surgery

  NPD (past)

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

• Northwestern Medical Center Inc

  dba Northwestern Medical Center

  • General Acute Care Hospital
  • Saint Albans, VT
  • NPI 1386689875
  Care Compare affiliation
• University of Vermont Medical Center Inc

  • General Acute Care Hospital
  • Burlington, VT
  • NPI 1568419976
  Care Compare affiliation
• Champlain Valley Physicians Hospital Medical Center

  • General Acute Care Hospital
  • Plattsburgh, NY
  • NPI 1033270699
  Care Compare affiliation

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348531200000",
    "number": "1154374734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 TILLEY DR",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054034440",
            "telephone_number": "802-847-2663",
            "fax_number": "802-847-3797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 TILLEY DR",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054034440",
            "telephone_number": "802-847-2663",
            "fax_number": "802-847-3797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLSON",
        "first_name": "MARK",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2012-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "VT",
            "license": "42-0011585",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "200400468",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "VT",
            "license": "42-0011585",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1015272",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Champlain Smile Solutions, PLLC
• Champlain Valley Cardiovascular Associates, PC
• Champlain Valley Neurology
• Champlain Valley Urgent Care, PC
• Gregory C Chan, DDS
• Kelly Charpentier, RN
• Chiropractic First PLC
• Jennifer Allison Choate, PT, DPT
• Cory Hunter Chrysogelos, MASSAGE THERAPIST
• City of So Burlington (So Burlington Fire & Rescue)

• Orthopaedic Foot and Ankle Surgery Physician in South Burlington, VT
• Providers in South Burlington, VT by specialty
• Orthopaedic Foot and Ankle Surgery Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.