Thomas Suppan, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

042-0009724 Issued in VT

Practice address

111 Colchester Ave
Burlington, VT 05401-1473

Phone

(802) 847-2377

Fax

(802) 847-9644

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pathology

Education

University of Vermont College of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwestern Medical Center IncGroup PAC ID 5496714313, 105 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Medical Center Inc Hospital, Saint Albans, VT, CCN 470024

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Northwestern Medical Center, Inc.

  • General Acute Care Hospital
  • Saint Albans, VT
  • NPI 1063546984
  Medicare reassignment Care Compare group NPD
• Northwestern Medical Center, Inc

  • Pediatrics Physician
  • Saint Albans, VT
  • NPI 1003574740
  NPD
• Northwestern Medical Center, Inc.

  • General Acute Care Hospital
  • Saint Albans, VT
  • NPI 1538293469
  NPD

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

• Northwestern Medical Center Inc

  • General Acute Care Hospital
  • Saint Albans, VT
  • NPI 1386689875
  Care Compare affiliation

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386679678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 S PROSPECT ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054013506",
            "telephone_number": "802-658-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-2377",
            "fax_number": "802-847-9644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPPAN",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "VT",
            "license": "042-0009724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0VN1782",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01866444",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mariel Sullivan
• Nicole Sullivan
• Robin Ann Sumner
• Samantha Mei Sun
• Sunrise Counseling and Wellness
• Benjamin Tate Suratt, M.D.
• Meta Eliza Surjaputra
• John Surprenant, LICSW
• Kate D. Suskin, M.S.W.
• Betsy L. Sussman, M.D.

• Anatomic Pathology & Clinical Pathology Physician in Burlington, VT
• Providers in Burlington, VT by specialty
• Anatomic Pathology & Clinical Pathology Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.