NPIMap

Individual provider Active NPI

Amanda M St Martin, MD

  • Emergency Medicine Physician
  • St Johnsbury, VT
National Provider Identifier
1508444845
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
042.0017604 Issued in VT
Practice address
1315 Hospital Dr
St Johnsbury, VT 05819-9210
Phone
(802) 748-8141
Fax
(802) 748-4098
NPI assigned
Mar 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 042.0017604 VT Primary
Emergency Medicine Physician 207P00000X 12985103-1205 UT

Addresses

Primary practice location

1315 Hospital Dr
St Johnsbury, VT 05819-9210

Mailing address

PO Box 905
St Johnsbury, VT 05819-0905
Phone (603) 545-8904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240806003291 VT Practitioner - Emergency Medicine 6002290426 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Boston University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeastern Vermont Regional Hospital IncGroup PAC ID 3678481405, shared by 15 NPIs, 104 clinicians

Practice addresses (Care Compare)

1315 Hospital Dr
Saint Johnsbury, VT 05819-9210
Phone (802) 748-8141

Hospital & facility affiliations

  • Northeastern Vermont Regional Hospital Hospital, Saint Johnsbury, VT, CCN 471303
  • Mary Hitchcock Memorial Hospital Hospital, Lebanon, NH, CCN 300003

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12985103-1205UTMDEmergency Medicine Physician
042.0017604VTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Vermont Regional Hospital Inc. CurrentSince Aug 1, 2024 Accepting new patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients
Northeastern Vermont Regional Hospital Inc Current Accepting new patients
Northeastern Vermont Regional Hospital, Inc CurrentSince Sep 1, 2025 Accepting new patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients
Northeastern Vermont Regional Hospital, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients

Locations

1315 Hospital Dr
St Johnsbury, VT 05819
Phone (802) 748-3638

Organizations & group practices 8

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.

Hospital & facility affiliations 5

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": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1508444845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 905",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058190905",
            "telephone_number": "603-545-8904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 HOSPITAL DR",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058199210",
            "telephone_number": "802-748-8141",
            "fax_number": "802-748-4098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST MARTIN",
        "first_name": "AMANDA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VT",
            "license": "042.0017604",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "12985103-1205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Johnsbury, VT

Sources for this page

Verify at the official NPI Registry.