Individual provider Active NPI

Justin A. Deangelis, M.D.

  • Obstetrics & Gynecology Physician
  • Burlington, VT
National Provider Identifier
1235471889
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
042.0013722 Issued in VT
Practice address
111 Colchester Ave
Burlington, VT 05401-1473
Phone
(802) 847-1400
Fax
(802) 847-8433
NPI assigned
Mar 21, 2013
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 042.0013722 VT Primary

Addresses

Primary practice location

111 Colchester Ave
Burlington, VT 05401-1473

Mailing address

111 Colchester Avenue
Uvm Medical Center - Women's Services
Burlington, VT 05401
Phone (802) 847-1400

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170911002510 VT Practitioner - Obstetrics/Gynecology 6507098837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Jefferson Medical College of Thomas Jefferson University, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc Obstetrics & Gynecology CurrentSince Aug 1, 2017 Accepting new patients
University of Vermont Medical Center Inc Past Accepting new patients

Locations

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

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

Interoperability endpoints

  • Direct secure messaging: jdeangelis177666@direct.uvmhealth.org

Organizations & group practices 2

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 1

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": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1235471889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVENUE",
            "address_2": "UVM MEDICAL CENTER - WOMEN'S SERVICES",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "05401",
            "telephone_number": "802-847-1400",
            "fax_number": "802-847-8433"
        },
        {
            "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": "802-847-1400",
            "fax_number": "802-847-8433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEANGELIS",
        "first_name": "JUSTIN",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VT",
            "license": "042.0013722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.