Individual provider Active NPI

Mitchell Edward Schwartz, M.D.

  • Specialist
  • South Burlington, VT
National Provider Identifier
1326041625
Registry record updated Jun 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0420009437 Issued in VT
Practice address
372 Dorset St
South Burlington, VT 05403-6212
Phone
(802) 660-8808
Fax
(802) 660-4310
NPI assigned
May 31, 2005
Reactivated
Apr 3, 2006
Last updated
Jun 19, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0420009437 VT Primary

Addresses

Primary practice location

372 Dorset St
South Burlington, VT 05403-6212

Mailing address

372 Dorset St
South Burlington, VT 05403-6212
Phone (802) 660-8808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0420009437VTMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Dorset Street Dermatology CurrentSince Jan 1, 1990 Accepting new patients
Integrated Dermatology of South Burlington, PLLC CurrentSince Jan 15, 2021 Accepting new patients

Locations

321 Dorset St
South Burlington, VT 05403
Phone (802) 393-8388

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.

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1326041625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "372 DORSET ST",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036212",
            "telephone_number": "802-660-8808",
            "fax_number": "802-660-4310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "372 DORSET ST",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036212",
            "telephone_number": "802-660-8808",
            "fax_number": "802-660-4310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARTZ",
        "first_name": "MITCHELL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2018-06-19",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VT",
            "license": "0420009437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Burlington, VT

Sources for this page

Verify at the official NPI Registry.