Active NPI
Spencer Ciancola
- Physician Assistant
- Bennington, VT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 055.0031452
- Practice address
- 140 Hospital Dr Ste 111
Bennington, VT 05201-5010 - Phone
- (802) 440-4077
- NPI assigned
- Jun 21, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 055.0031452 | VT | Primary |
Addresses
Primary practice location
140 Hospital Dr Ste 111
Bennington, VT 05201-5010
Mailing address
100 Hospital Dr
Bennington, VT 05201-5004
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: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200319000687 | VT | Practitioner - Physician Assistant | 4688002918 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southwestern Vermont Medical Center, Inc
Practice addresses (Care Compare)
140 Hospital Dr
Bennington, VT 05201-5010
140 Hospital Dr
Bennington, VT 05201-5018
Hospital & facility affiliations
- Southwestern Vermont Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwestern Vermont Medical Center Inc. | Current | Accepting new patients | |
| Southwestern Vermont Medical Center Inc. | Current | Accepting new patients | |
| Southwestern Vermont Medical Center, Inc | Past | Accepting new patients |
Locations
100 Hospital Dr
Bennington, VT 05201
Phone (802) 447-4509
120 Hospital Dr
Bennington, VT 05201
Phone (802) 440-4077
100 Hospital Dr
#44
Bennington, VT 05201
Phone (802) 442-4509
140 Hospital Dr
Ste 116
Bennington, VT 05201
Phone (802) 447-1836
140 Hospital Dr
Ste 111
Bennington, VT 05201
Phone (719) 362-7244
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Bennington, VT
- NPI 1184994162
VT
-
- General Acute Care Hospital
- Bennington, VT
- NPI 1205865789
VT
-
- Orthopaedic Surgery Physician
- Bennington, VT
- NPI 1487930632
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bennington, VT
- NPI 1205865789
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640476800000",
"number": "1285295154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 HOSPITAL DR",
"city": "BENNINGTON",
"state": "VT",
"postal_code": "052015004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 HOSPITAL DR STE 111",
"city": "BENNINGTON",
"state": "VT",
"postal_code": "052015010",
"telephone_number": "802-440-4077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CIANCOLA",
"first_name": "SPENCER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-06-21",
"last_updated": "2021-12-26",
"certification_date": "2021-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VT",
"license": "055.0031452",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bennington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.