Susan A. Brodeur, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

055.0031295 Issued in VT

Practice address

77 Weed Rd
Essex Junction, VT 05452-2724

Phone

(802) 871-0246

Fax

(802) 332-3117

NPI assigned

Jul 3, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Albany Medical College of Union University, 2015

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hope in Recovery

  • Addiction Psychiatry Physician
  • Essex Junction, VT
  • NPI 1144059031
  Medicare reassignment NPD Authorized official
• Northwestern Medical Center, Inc.

  • General Acute Care Hospital
  • Saint Albans, VT
  • NPI 1720112659
  NPD (past)
• Total Wellness Centers, LLC

  • Addiction Medicine (Internal Medicine) Physician
  • West Springfield, MA
  • NPI 1770816506

  Psychiatry

  NPD (past)

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

{
    "created_epoch": "1435881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720224000000",
    "number": "1477936847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 WEED RD",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "054522724",
            "telephone_number": "802-871-0246",
            "fax_number": "802-332-3117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 WEED RD",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "054522724",
            "telephone_number": "802-871-0246",
            "fax_number": "802-332-3117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODEUR",
        "first_name": "SUSAN",
        "middle_name": "A.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-03",
        "last_updated": "2024-07-06",
        "certification_date": "2024-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "055.0031295",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VT",
            "license": "055.0031295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheren Boca, PHARMD / RPH
• Mary Carter Bradshaw, MSW
• Nicole Lafko Breslend, PH.D.
• Shane Isaac Brichacek, PHARMD
• Laura Bristol, DPT
• Tina Brownley-Stevenson
• Aaron Wallace Burley
• Thomas F Busby, DC,LACP
• Rebecca Marie Busier, O.D.
• Judith Cabanaw, RN, IBCLC

• Medical Physician Assistant in Essex Junction, VT
• Providers in Essex Junction, VT by specialty
• Medical Physician Assistant in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.