Individual provider Active NPI

Kathleen Burgess, MD

  • Family Medicine Physician
  • Brattleboro, VT
National Provider Identifier
1265402382
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
042.0011317 Issued in VT
Practice address
19 Belmont Ave Ste 103
Brattleboro, VT 05301-6761
Phone
(802) 258-3905
NPI assigned
Jan 23, 2006
Last updated
Jun 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 209588 MA
Family Medicine Physician 207Q00000X 042.0011317 VT Primary

Addresses

Primary practice location

19 Belmont Ave Ste 103
Brattleboro, VT 05301-6761

Mailing address

600 Blair Park Rd Ste 285
Williston, VT 05495-7586
Phone (802) 288-1140

Other practice location 1

21 Belmont Ave
Brattleboro, VT 05301-7110
Phone (802) 258-3905 ext. 111

Other practice location 2

338 Montague City Rd
Turners Falls, MA 01376-1830
Phone (413) 772-3748 ext. 111

Other identifiers 1

IdentifierTypeStateIssuer
1301128MedicaidMA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drburgess@pchpmd.medentdirect.com Direct

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
I20080211000224 VT Practitioner - Family Practice 6608959929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of New York at Stony Brook, School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Care Health Partners - Vermont LLPGroup PAC ID 7810896032, 21 clinicians

Practice addresses (Care Compare)

21 Belmont Ave
Brattleboro, VT 05301-7110
Phone (802) 258-3905

6410 Rockledge Dr
Suite 600
Bethesda, MD 20817-1844

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209588MAMDFamily Medicine Physician
042.0011317VTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Health Partners - New York LLP Family Medicine CurrentSince Jul 2, 2023 Accepting new patients
Primary Care Health Partners - Vermont LLP Family Medicine CurrentSince Sep 15, 2017 Accepting new patients
Primary Care Health Partners PastSince Dec 6, 2022 Accepting new patients
Conemaugh Health Initiatives Family Medicine Past Accepting new patients
Primary Care Health Partners Past Accepting new patients
Southern Vermont Health Services Corp PastSince Aug 23, 2020 Accepting new patients

Locations

19 Belmont Ave
Ste 103
Brattleboro, VT 05301
Phone (802) 257-1444

51 Timber Ln
South Burlington, VT 05403
Phone (802) 864-0521

600 Blair Park Rd
Ste 285
Williston, VT 05495
Phone (802) 288-1140

66 Knight Ln
Ste 10
Williston, VT 05495
Phone (802) 872-4327

Interoperability endpoints

  • Direct secure messaging: drburgess@pchpmd.medentdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1265402382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 BLAIR PARK RD STE 285",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054957586",
            "telephone_number": "802-288-1140",
            "fax_number": "802-288-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 BELMONT AVE STE 103",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053016761",
            "telephone_number": "802-258-3905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Belmont Ave",
            "address_purpose": "LOCATION",
            "city": "Brattleboro",
            "state": "VT",
            "postal_code": "053017110",
            "country_code": "US",
            "telephone_number": "802-258-3905 x111",
            "fax_number": "802-258-4903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "338 Montague City Rd",
            "address_purpose": "LOCATION",
            "city": "Turners Falls",
            "state": "MA",
            "postal_code": "013761830",
            "country_code": "US",
            "telephone_number": "413-772-3748 x111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "KATHLEEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "209588",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "042.0011317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1301128",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drburgess@pchpmd.medentdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "19 Belmont Ave Ste 103",
            "city": "Brattleboro",
            "state": "VT",
            "country_code": "US",
            "postal_code": "053016761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brattleboro, VT

Sources for this page

Verify at the official NPI Registry.