Associates in Gastroenterology, PLLC
Organization Active NPI Gastroenterology Physician · Colchester, VT
NPI 1346496783 · NPPES record last updated Aug 20, 2024
Key facts
- NPI
- 1346496783
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Gastroenterology Physician 207RG0100X
- Legal business name
- ASSOCIATES IN GASTROENTEROLOGY, PLLC
- Practice address
- 875 Roosevelt Hwy
Suite 132
Colchester, VT 05446-4460 - Phone
- (802) 864-7483
- Fax
- (802) 660-4337
- NPI assigned
- Aug 18, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Alex John, M.D.
- Title
- President
- Phone
- (802) 864-7483
Practitioners 7
-
Cory Halliburton, M.D.
-
Alan Landau, M.D.
-
Allison Catherine Mack, APRN
-
Jacek Mysior, M.D.
-
David Neal Schwartz, MD, FACG
-
Alex John, M.D.
-
Fady Asslo, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 47D0856802 | Associates in Gastroenterology PLLC | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090611000707 | VT | Part B Supplier - Clinic/Group Practice | 9931259967 |
Receives reassigned benefits from 7 practitioners Practice locations: Colchester, VT |
National Provider Directory
Locations
875 Roosevelt Hwy
Colchester, VT 05446
Phone (802) 864-7483
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician |
207RG0100X | Yes |
Addresses
Primary practice location
875 Roosevelt Hwy
Suite 132
Colchester, VT 05446-4460
Mailing address
875 Roosevelt Hwy
Suite 132
Colchester, VT 05446-4460
Phone (802) 864-7483
Other names
- Vermont Gastroenterology
Other providers in Colchester, VT
- Bonnie Aloisi
- Alpine Family Dental LLC
- Charles Edwin Anderson
- Anesthesia Associates of Vermont PLC
- Arthritis & Rheumatology Center, PLC
- Elizabeth Backhaus
- Matthew James Bain
- Patricia A Bardshar
- Michele Lynne Barnier
- Kayla Barrow
All providers in Colchester, VT · Gastroenterology Physician in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.