NPIMap

Individual provider Active NPI

Jason Douglas Brazelton, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Burlington, VT
National Provider Identifier
1407098957
Registry record updated Aug 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
042.0014078 Issued in VT
Practice address
111 Colchester Ave
Burlington, VT 05401
Phone
(802) 847-5121
NPI assigned
Mar 30, 2009
Last updated
Aug 3, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 175972 OR
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 042.0014078 VT Primary

Addresses

Primary practice location

111 Colchester Ave
Burlington, VT 05401

Mailing address

1348 NE Cushing Dr
Suite 200
Bend, OR 97701-3876
Phone (541) 382-7696

Other names 1

  • Jason Douglas Brazelton-Hughes Former name

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
I20180822003754 VT Practitioner - PathologyPractitioner - HematologyPractitioner - Hematology/Oncology 3274779087 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
PathologyAlso: Hematology, Hematology/Oncology
Education
University of South Alabama College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
175972ORMDAnatomic Pathology & Clinical Pathology Physician
042.0014078VTMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Center, Inc CurrentSince Nov 1, 2018 Accepting new patients
Central Vermont Medical Center Inc CurrentSince Aug 1, 2018 Accepting new patients
Northwestern Medical Center, Inc. CurrentSince Nov 1, 2018 Accepting new patients
Copley Hospital, Inc CurrentSince Mar 6, 2023 Accepting new patients
Copley Hospital, Inc. Current Accepting new patients
Copley Hospital, Inc. Current Accepting new patients
Northwestern Medical Center, Inc. Current Accepting new patients
Copley Hospital, Inc. Current Accepting new patients
Copley Hospital Inc Current Accepting new patients
Central Vermont Medical Center Inc CurrentSince Aug 1, 2018 Accepting new patients
Copley Hospital, Inc. CurrentSince Mar 6, 2023 Accepting new patients

Locations

130 Fisher Rd
Barre, VT 05641
Phone (802) 371-4235

130 Fisher Rd
#C
Berlin, VT 05602
Phone (802) 225-5400

528 Washington Hwy
Morrisville, VT 05661
Phone (802) 888-4231

133 Fairfield St
Saint Albans, VT 05478
Phone (802) 524-1227

Interoperability endpoints

  • Direct secure messaging: jbrazelton47526@direct.uvmhealth.org

Organizations & group practices 12

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533254400000",
    "number": "1407098957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1348 NE CUSHING DR",
            "address_2": "SUITE 200",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013876",
            "telephone_number": "541-382-7696",
            "fax_number": "541-389-5723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "05401",
            "telephone_number": "802-847-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAZELTON",
        "first_name": "JASON",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-30",
        "last_updated": "2018-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OR",
            "license": "175972",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "VT",
            "license": "042.0014078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JASON",
            "last_name": "BRAZELTON-HUGHES",
            "middle_name": "DOUGLAS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.