Liana Dagdavaryan
Individual provider Active NPI Anesthesiology Physician · Burlington, VT
NPI 1457712408 · NPPES record last updated Dec 11, 2023
Key facts
- NPI
- 1457712408
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 032-0134152 (VT)
- Practice address
- 111 Colchester Ave
Burlington, VT 05401-1473 - Phone
- (802) 847-2415
- NPI assigned
- Mar 17, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Anesthesiology
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- University of Vermont Medical Center Inc
Practice addresses (Care Compare)
111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000
Hospital & facility affiliations
- Univ. of Vermont - Fletcher Allen Health Care
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231218001947 | VT | Practitioner - Anesthesiology | 4183989882 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Vermont Medical Center Inc | Anesthesiology | Current |
Accepting new patients |
| Western University of Health Sciences | Past | Accepting new patients |
Locations
111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415
1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531
Interoperability endpoints
- ldagdavaryan585616@direct.med.utah.edu
- ldagdavaryan188624@direct.uvmhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 12822273-1204 | UT | |
| Anesthesiology Physician | 207L00000X | 032-0134152 | VT | Yes |
Addresses
Primary practice location
111 Colchester Ave
Burlington, VT 05401-1473
Mailing address
200 Mullins Dr
Lebanon, OR 97355-3983
Other practice location 1
200 Mullins Dr
Lebanon, OR 97355-3983
Phone (541) 259-0200
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | LDAGDAVARYAN585616@DIRECT.MED.UTAH.EDU | Direct | University of Utah |
Other providers in Burlington, VT
- Sarah D'Agostino
- Jenifer D'Aiello
- Danielle Robillard D'Amico
- Michael A D'Amico
- Ruth D'Angelo
- Manavi Romit Dalal
- Rosemary L Dale
- Emily Dalton
- Melissa M Daltry
- Madison Lynn Daly
All providers in Burlington, VT · Anesthesiology 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 Dec 11, 2023. 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.
- Order and Referring (CMS).
- 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.