NPIMap

Individual provider Active NPI

Maxwell T Vergo, M.D.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Lebanon, NH
National Provider Identifier
1205894813
Registry record updated Jul 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
15684 Issued in NH
Practice address
1 Medical Center Dr
DHMC, Department of Anesthesia, Palliative Care
Lebanon, NH 03756-1000
Phone
(603) 650-5402
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 15684 NH Primary
Medical Oncology Physician 207RX0202X 15684 NH

Addresses

Primary practice location

1 Medical Center Dr
DHMC, Department of Anesthesia, Palliative Care
Lebanon, NH 03756-1000

Mailing address

1 Medical Center Dr
DHMC, Department of Anesthesia, Palliative Care
Lebanon, NH 03756-1000
Phone (603) 650-5402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120906000885 NH Practitioner - Hospice/Palliative Care 5991804635 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative Care
Education
Tufts University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dartmouth-Hitchcock ClinicGroup PAC ID 4183537509, 1,445 clinicians
Mary Hitchcock Memorial HospitalGroup PAC ID 4486561164, 1,269 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15684NHMDHospice and Palliative Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital CurrentSince Jul 9, 2012 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jul 9, 2012 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Jul 9, 2012 Accepting new patients

Locations

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

Interoperability endpoints

  • Direct secure messaging: mvergo92975@direct.dartmouth-hitchcock.org

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341446400000",
    "number": "1205894813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "DHMC, DEPARTMENT OF ANESTHESIA, PALLIATIVE CARE",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-5402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "DHMC, DEPARTMENT OF ANESTHESIA, PALLIATIVE CARE",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-5402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERGO",
        "first_name": "MAXWELL",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2012-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NH",
            "license": "15684",
            "primary": true
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NH",
            "license": "15684",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.