Individual provider Active NPI

Lauren Iacono, D.O.

  • Pediatric Endocrinology Physician
  • Burlington, VT
National Provider Identifier
1164886552
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
032-0134147 Issued in VT
Practice address
111 Colchester Ave
Burlington, VT 05401-1473
Phone
(802) 847-0000
NPI assigned
Apr 12, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Endocrinology Physician 2080P0205X 032-0134147 VT Primary

Addresses

Primary practice location

111 Colchester Ave
Burlington, VT 05401-1473

Mailing address

99 Woodland St
Hartford, CT 06105-1207

Other practice location 1

3411 Wayne Ave
Bronx, NY 10467-2509
Phone (718) 920-4664

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
I20231024001896 VT Practitioner - Pediatric Medicine 5698069615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
032-0134147VTMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc CurrentSince Oct 12, 2023 Accepting new patients

Locations

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

Interoperability endpoints

  • Direct secure messaging: liacono534320@direct.uvmhealth.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1164886552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 WOODLAND ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3411 Wayne Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672509",
            "country_code": "US",
            "telephone_number": "718-920-4664",
            "fax_number": "718-405-5609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IACONO",
        "first_name": "LAUREN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-12",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "VT",
            "license": "032-0134147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.