Individual provider Active NPI

Kristen Destigter, MD

  • Body Imaging Physician
  • Burlington, VT
National Provider Identifier
1265459044
Registry record updated Oct 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Body Imaging PhysicianTaxonomy code 2085B0100X
License
042-0010186 Issued in VT
Practice address
111 Colchester Ave
Dept. of Radiology
Burlington, VT 05401-1473
Phone
(802) 847-3592
Fax
(802) 847-4822
NPI assigned
Jul 16, 2006
Last updated
Oct 7, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X 042-0010186 VT Primary

Addresses

Primary practice location

111 Colchester Ave
Dept. of Radiology
Burlington, VT 05401-1473

Mailing address

111 Colchester Ave
Patrick 117
Burlington, VT 05401-1473
Phone (802) 847-3592

Other identifiers 1

IdentifierTypeStateIssuer
OVN2536MedicaidVT

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
I20050310000203 VT Practitioner - Diagnostic Radiology 2961456124 Reassigns benefits to 4 organizations
I20240626000499 NY Practitioner - Diagnostic Radiology 2961456124 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042-0010186VTMDBody Imaging Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Vermont Medical Center Inc CurrentSince May 4, 2024 Accepting new patients
Elizabethtown Community Hospital CurrentSince May 16, 2024 Accepting new patients
Alice Hyde Medical Center Current Accepting new patients
Champlain Valley Physicians Hospital Medical Center CurrentSince May 13, 2024 Accepting new patients
Porter Hospital, Inc CurrentSince May 4, 2024 Accepting new patients
Alice Hyde Medical Center CurrentSince May 16, 2024 Accepting new patients
Porter Hospital Inc Current Accepting new patients
Elizabethtown Community Hospital Current Accepting new patients
North Country Hospital & Health Center Inc Past Accepting new patients
Alice Hyde Medical Center Past Accepting new patients

Locations

969 State Route 11
Moira, NY 12957
Phone (518) 529-7847

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

101 Adirondack Dr
Ste 1
Ticonderoga, NY 12883
Phone (518) 585-2831

130 Fisher Rd
Berlin, VT 05602
Phone (802) 225-5820

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

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

111 Colchester Ave
#117
Burlington, VT 05401

104 Porter Dr
Middlebury, VT 05753
Phone (802) 388-5682

115 Porter Dr
Middlebury, VT 05753
Phone (802) 388-4701

82 Catamount Park
Middlebury, VT 05753
Phone (802) 388-7185

44 S Main St
Randolph, VT 05060
Phone (802) 728-4441

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/elizabe-e663f886
  • Direct secure messaging: kdestigter38613@direct.uvmhealth.org

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381104000000",
    "number": "1265459044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "address_2": "PATRICK 117",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-3592",
            "fax_number": "802-847-4822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "address_2": "DEPT. OF RADIOLOGY",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-3592",
            "fax_number": "802-847-4822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESTIGTER",
        "first_name": "KRISTEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2013-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "VT",
            "license": "042-0010186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN2536",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.