Individual provider Active NPI

Maria G Carracino, M.D.

  • Obstetrics & Gynecology Physician
  • Essex Junction, VT
National Provider Identifier
1457570954
Registry record updated Aug 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
042-0012266 Issued in VT
Practice address
55 Main St.
Suite 3 Champlain Obstetrics & Gynecology
Essex Junction, VT 05452
Phone
(802) 879-1802
Fax
(802) 878-6131
NPI assigned
Apr 24, 2007
Last updated
Aug 8, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 042-0012266 VT Primary

Addresses

Primary practice location

55 Main St.
Suite 3 Champlain Obstetrics & Gynecology
Essex Junction, VT 05452

Mailing address

55 Main St.
Suite 3 Champlain Obstetrics & Gynecology
Essex Junction, VT 05452
Phone (802) 879-1802

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120420000274 VT Practitioner - Obstetrics/Gynecology 9436310331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Vermont College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Champlain Obstetrics and Gynecology, P.C.Group PAC ID 8325127137, 3 clinicians

Practice addresses (Care Compare)

55 Main St
Suite 3
Essex Junction, VT 05452-6100
Phone (802) 879-1802

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042-0012266VTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Champlain Obstetrics and Gynecology, P.C. Obstetrics & Gynecology CurrentSince Dec 13, 2011 Accepting new patients

Locations

55 Main St
Ste 3
Essex Junction, VT 05452
Phone (802) 383-0039

Organizations & group practices 1

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 1

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": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312761600000",
    "number": "1457570954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 MAIN ST.",
            "address_2": "SUITE 3 CHAMPLAIN OBSTETRICS & GYNECOLOGY",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "05452",
            "telephone_number": "802-879-1802",
            "fax_number": "802-878-6131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MAIN ST.",
            "address_2": "SUITE 3 CHAMPLAIN OBSTETRICS & GYNECOLOGY",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "05452",
            "telephone_number": "802-879-1802",
            "fax_number": "802-878-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRACINO",
        "first_name": "MARIA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2011-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VT",
            "license": "042-0012266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Essex Junction, VT

Sources for this page

Verify at the official NPI Registry.