Individual provider Active NPI

Peter Matthias Bingham, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Burlington, VT
National Provider Identifier
1215955430
Registry record updated Oct 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
0420010083 Issued in VT
Practice address
110 Colchester Ave
East Pavilon, Level 4
Burlington, VT 05401-1473
Phone
(802) 847-4589
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 0420010083 VT
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 0420010083 VT Primary

Addresses

Primary practice location

110 Colchester Ave
East Pavilon, Level 4
Burlington, VT 05401-1473

Mailing address

110 Colchester Avenue
Burlington, VT 05490
Phone (802) 847-4589

Other identifiers 1

IdentifierTypeStateIssuer
OVN2367MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090113000041 VT Practitioner - Neurology 1850454190 Reassigns benefits to 2 organizations
I20171129002605 NY Practitioner - Neurology 1850454190 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Columbia University College of Physicians and Surgeons, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Vermont Medical Center IncGroup PAC ID 3779491071, 1,208 clinicians

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0420010083VTMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System CurrentSince Dec 23, 2024 Accepting new patients
Bronxcare Health System Neurology CurrentSince Dec 23, 2024 Accepting new patients
Central Vermont Medical Center Inc Neurology CurrentSince Jul 22, 2022 Accepting new patients
University of Vermont Medical Center Inc CurrentSince Oct 17, 2006 Accepting new patients
Champlain Valley Physicians Hospital Medical Center CurrentSince Sep 4, 2017 Accepting new patients
Bronxcare Health System Past Accepting new patients
Fletcher Allen Health Care Inc Past Accepting new patients

Locations

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

75 Beekman St
Plattsburgh, NY 12901
Phone (518) 562-7100

130 Fisher Rd
#C
Berlin, VT 05602
Phone (802) 225-5400

111 Colchester Ave
Fl 4
Burlington, VT 05401
Phone (802) 847-1400

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

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: pbingham3914@direct.uvmhealth.org

Organizations & group practices 7

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381363200000",
    "number": "1215955430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 COLCHESTER AVENUE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "05490",
            "telephone_number": "802-847-4589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 COLCHESTER AVE",
            "address_2": "EAST PAVILON, LEVEL 4",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-4589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BINGHAM",
        "first_name": "PETER",
        "middle_name": "MATTHIAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2013-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VT",
            "license": "0420010083",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "VT",
            "license": "0420010083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN2367",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.