Alexander Jacob Rovner, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

060.0005973 Issued in VT

Practice address

111 Colchester Ave
Burlington, VT 05401-1473

Phone

(802) 847-0000

NPI assigned

Jun 28, 2022

Reactivated

Jul 13, 2023

Last updated

Jul 1, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1215669205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-0000"
        },
        {
            "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": [],
    "basic": {
        "last_name": "ROVNER",
        "first_name": "ALEXANDER",
        "middle_name": "JACOB",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-28",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "deactivation_date": "2023-05-30",
        "reactivation_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VT",
            "license": "060.0005973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DO NOT HAVE",
            "identifier": "000000000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vy Bui Rossi, MD
• Lindsey Korotash Roth, CRNA
• Samantha Anne Rothberg, MS
• Cody Thomas Rounds, M.A.
• Molly Lynn Rovin, M.D.
• Kylee Rowden
• Chantal Roy-Hewitson, M.D.
• Brian D Roy
• Pragma Laboni Roy, MD
• Alan Saul Rubin, MD

• Pediatrics Physician in Burlington, VT
• Providers in Burlington, VT by specialty
• Pediatrics Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.