Individual provider Active NPI

Stephen John Merena, DPM

  • Foot Surgery Podiatrist
  • South Burlington, VT
National Provider Identifier
1194758557
Registry record updated Jan 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
056-0000174 Issued in VT
Practice address
192 Tilley Dr
South Burlington, VT 05403-4440
Phone
(802) 847-2663
Fax
(802) 847-3828
NPI assigned
Jul 9, 2006
Last updated
Jan 15, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 056-0000174 VT Primary

Addresses

Primary practice location

192 Tilley Dr
South Burlington, VT 05403-4440

Mailing address

192 Tilley Dr
South Burlington, VT 05403-4440
Phone (802) 847-2663

Other identifiers 2

IdentifierTypeStateIssuer
48378OtherVTBC/BS
0VN2096MedicaidVT

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050606000647 VT Practitioner - Podiatry 1456394907 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 S Prospect St
Burlington, VT 05401-3456
Phone (802) 847-0000

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

192 Tilley Dr
Orthopeadic
S Burlington, VT 05403-4440
Phone (802) 847-4690

790 College Pkwy
Colchester, VT 05446-3007
Phone (802) 847-0000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue11
Removal of nail tissue29
Removal or shaving of skin growth21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056-0000174VTMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Porter Hospital, Inc CurrentSince Oct 1, 2018 Accepting new patients
University of Vermont Medical Center Inc CurrentSince Jun 1, 2011 Accepting new patients
Champlain Valley Foot & Ankle, P.C. Foot Surgery PastSince Mar 18, 2005 Accepting new patients
Middlebury Foot Care, Inc. Foot Surgery Past Accepting new patients

Locations

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

104 Porter Dr
Middlebury, VT 05753
Phone (802) 388-5682

115 Porter Dr
Middlebury, VT 05753
Phone (802) 388-4701

82 Catamount Park
Middlebury, VT 05753
Phone (802) 388-7185

192 Tilley Dr
South Burlington, VT 05403
Phone (802) 847-2663

Interoperability endpoints

  • Direct secure messaging: smerena48017@direct.uvmhealth.org

Organizations & group practices 4

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 2

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421280000000",
    "number": "1194758557",
    "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": "802-847-3828"
        },
        {
            "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": "802-847-3828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERENA",
        "first_name": "STEPHEN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2015-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "VT",
            "license": "056-0000174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "48378",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0VN2096",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Burlington, VT

Sources for this page

Verify at the official NPI Registry.