Ivan Levin, M.D.
Individual provider Active NPI Internal Medicine Physician · Windsor, VT
NPI 1477848240 · NPPES record last updated Jun 29, 2017
Key facts
- NPI
- 1477848240
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 042.0012922 (VT)
- Practice address
- 289 County Rd
Windsor, VT 05089-9000 - Phone
- (774) 253-7402
- NPI assigned
- Jun 9, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 19
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Windsor Hospital Corporation
Practice addresses (Care Compare)
289 County Rd
Windsor, VT 05089-9000
Phone (802) 674-7220
Hospital & facility affiliations
- Vna and Hospice of Vermont and New Hampshire
- Lake Sunapee Home Care & Hospice
- Bayada Home Health Care, Inc.
- Mt Ascutney Hospital
- Mary Hitchcock Memorial Hospital
- Valley Regional Hospital
- Alice Peck Day Memorial Hospital
- Springfield Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in VT, IL
- 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 |
|---|---|---|---|---|
| I20141024001770 | VT | Practitioner - Internal Medicine | 2365663804 | Reassigns benefits to 3 organizations |
| I20200323001548 | IL | Practitioner - Internal Medicine | 2365663804 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125059040 | IL | MD | Internal Medicine Physician |
| 042.0012922 | VT | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Windsor Hospital Corporation | Current | Accepting new patients | |
| Windsor Hospital Corporation | Current |
Accepting new patients | |
| Endeavor Health Medical Group | Current |
Accepting new patients | |
| Windsor Hospital Corporation | Internal Medicine | Current |
Accepting new patients |
| Endeavor Health Medical Group | Internal Medicine | Current |
Accepting new patients |
| Windsor Hospital Corporation | Current |
Accepting new patients |
Locations
9532 Eagle Way
Chicago, IL 60678
2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222
2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175
289 County Rd
Windsor, VT 05089
Phone (802) 674-7220
Interoperability endpoints
- ilevin622871@direct.dartmouth-hitchcock.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 125059040 | IL | |
| Internal Medicine Physician | 207R00000X | 042.0012922 | VT | Yes |
Addresses
Primary practice location
289 County Rd
Windsor, VT 05089-9000
Mailing address
289 County Rd
Windsor, VT 05089-9000
Phone (802) 674-7300
Other providers in Windsor, VT
- Jeffrey R King
- Cynthia Jean Koch
- Maryann Lachapelle
- Peter Gilbert Lapre
- Katherine Jane Leary
- Alan Lovell
- Patrick Lyons
- Katherine A Macko
- Richard A Marasa
- Shona Marston
All providers in Windsor, VT · Internal Medicine 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 Jun 29, 2017. 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.