Isaac Liam Bass, PMHNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Middlebury, VT
NPI 1194546200 · NPPES record last updated Oct 25, 2024
Key facts
- NPI
- 1194546200
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 026.0147432 (VT)
- Practice address
- 88 Main St Ste 201
Middlebury, VT 05753-1425 - Phone
- (413) 687-5175
- NPI assigned
- Oct 21, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Community Health Centers of Burlington Inc
Long Trail Psychiatry LLC
Practice addresses (Care Compare)
617 Riverside Ave
Burlington, VT 05401-1601
Phone (802) 864-6309
99 Maple St
Suite 14
Middlebury, VT 05753-1231
Phone (802) 349-1747
Hospital & facility affiliations
- Univ. of Vermont - Fletcher Allen Health Care
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 |
|---|---|---|---|---|
| I20250205001920 | VT | Practitioner - Nurse Practitioner | 0042740102 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 026.0147432 | VT | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Centers of Burlington Inc | Current |
Accepting new patients | |
| Long Trail Psychiatry, LLC | Psychiatric/Mental Health | Current |
Accepting new patients |
| Community Health Centers of Burlington Inc | Current |
Accepting new patients |
Locations
789 Pine St
Burlington, VT 05401
Phone (802) 264-1052
617 Riverside Ave
Burlington, VT 05401
Phone (802) 264-8158
88 Main St
Ste 201
Middlebury, VT 05753
Phone (413) 687-5175
99 Maple St
Ste 14
Middlebury, VT 05753
Phone (802) 234-8645
Interoperability endpoints
- isaac.bass.p1@direct.chcb.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 026.0147432 | VT | Yes |
Addresses
Primary practice location
88 Main St Ste 201
Middlebury, VT 05753-1425
Mailing address
88 Main St Ste 201
Middlebury, VT 05753-1425
Phone (413) 687-5175
Other providers in Middlebury, VT
- Areum Ban
- Dragos Banu
- Natasha Baranow
- Mika Barker-Hart
- Laura Anne Basili
- Janet Lawson Bates
- Marion D Bauer
- Benjamin I Bearnot
- John James Beattie
- Barbara Conger Beatty
All providers in Middlebury, 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 Oct 25, 2024. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.