Jacob Miller Tadje

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

University of Vermont Medical Center
Burlington, VT 05405-0001

Phone

(802) 656-3806

NPI assigned

Mar 20, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1710892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1467212050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 N TIMBER RIDGE LN",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165619",
            "telephone_number": "208-995-3616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF VERMONT MEDICAL CENTER",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054050001",
            "telephone_number": "802-656-3806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADJE",
        "first_name": "JACOB",
        "middle_name": "MILLER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-20",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Szkaradnik, LICSW
• Alexandra Mae Szotka, MS
• Marielena Louisa Szumowski, LICSW
• Diane Tabachnick, PA-C
• Kreager Anne Taber, MD
• Sarah Grace Gibbs Tadje, MD
• Tage Lilja Licsw PLC
• Michelle Tahair, BCBA
• Amanda Marie Talbert, LCMHC
• Talk of the Town, LLC

• Student in an Organized Health Care Education/Training Program in Burlington, VT
• Providers in Burlington, VT by specialty
• Student in an Organized Health Care Education/Training Program in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; 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.

Verify at the official NPI Registry.