NPIMap

Individual provider Active NPI

Michael J Kiernan, MD

  • Emergency Medicine Physician
  • Middlebury, VT
National Provider Identifier
1295839454
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0420008897 Issued in VT
Practice address
115 Porter Dr
Porter Hospital
Middlebury, VT 05753
Phone
(802) 388-4001
Fax
(802) 388-5612
NPI assigned
Sep 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0420008897 VT Primary

Addresses

Primary practice location

115 Porter Dr
Porter Hospital
Middlebury, VT 05753

Mailing address

115 Porter Dr
C/O Susan Spitzner Finance Dept
Middlebury, VT 05753
Phone (802) 388-5607

Other identifiers 2

IdentifierTypeStateIssuer
OVN0886MedicaidVT
19689OtherVTBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060329000501 VT Practitioner - Family PracticePractitioner - Emergency Medicine 1355359514 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Saint Louis University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Porter Hospital IncGroup PAC ID 1850365180, 116 clinicians

Practice addresses (Care Compare)

115 Porter Dr
Middlebury, VT 05753-8423
Phone (802) 382-3443

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0420008897VTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Porter Hospital Inc Current Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: mkiernan113310@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 and National Provider Directory roles.

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295839454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 PORTER DR",
            "address_2": "C/O SUSAN SPITZNER FINANCE DEPT",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "05753",
            "telephone_number": "802-388-5607",
            "fax_number": "802-388-5654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 PORTER DR",
            "address_2": "PORTER HOSPITAL",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "05753",
            "telephone_number": "802-388-4001",
            "fax_number": "802-388-5612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIERNAN",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VT",
            "license": "0420008897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN0886",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "19689",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlebury, VT

Sources for this page

Verify at the official NPI Registry.