Active NPI
Julie L. Debacker, M.D.
- Neurology Physician
- Burlington, VT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 042.0013214
- Practice address
- 111 Colchester Ave
Uvm Medical Center - Dept. of Neurology
Burlington, VT 05401-1473 - Phone
- (802) 847-4589
- Fax
- (802) 847-2461
- NPI assigned
- Apr 21, 2011
- Last updated
- Dec 6, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Neurology Physician | 2084N0400X | 042.0013214 | VT | Primary |
Addresses
Primary practice location
111 Colchester Ave
Uvm Medical Center - Dept. of Neurology
Burlington, VT 05401-1473
Mailing address
111 Colchester Ave
Uvm Medical Center - Dept. of Neurology
Burlington, VT 05401-1473
Phone (802) 847-4589
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042.0013214 | VT | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York University | Current | Accepting new patients | |
| New York University | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| NYU Langone Hospitals | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| NYU Langone Hospitals | Current | Accepting new patients | |
| NYU Langone Hospitals | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients |
Locations
4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784
393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914
888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400
5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2930
301 E 17th St
New York, NY 10003
Phone (212) 598-2454
14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224
Organizations & group practices 8
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.
-
dba NYU Faculty Group Practice
- Cardiovascular Disease Physician
- Boynton Beach, FL
- NPI 1285826438
NY
-
- Internal Medicine Physician
- New York, NY
- NPI 1790975944
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
dba NYU Langone Ambulatory Care Chelsea
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
-
dba NYU Langone Hospital - Suffolk
- Psychiatric Hospital Unit
- Patchogue, NY
- NPI 1508687021
-
dba NYU Lutheran Family Health Center Quality Care Group
- Multi-Specialty Clinic/Center
- Brooklyn, NY
- NPI 1831549559
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Health Maintenance Organization
- Woodland Hills, CA
- NPI 1952333478
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638748800000",
"number": "1346531639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 COLCHESTER AVE",
"address_2": "UVM MEDICAL CENTER - DEPT. OF NEUROLOGY",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054011473",
"telephone_number": "802-847-4589",
"fax_number": "802-847-2461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 COLCHESTER AVE",
"address_2": "UVM MEDICAL CENTER - DEPT. OF NEUROLOGY",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054011473",
"telephone_number": "802-847-4589",
"fax_number": "802-847-2461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEBACKER",
"first_name": "JULIE",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-21",
"last_updated": "2021-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "VT",
"license": "042.0013214",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "4733 W Sunset Blvd",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900276021",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.