Individual provider Active NPI

John G Koutras, M.D.

  • Psychiatry Physician
  • Burlington, VT
National Provider Identifier
1528154697
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
042.0010844 Issued in VT
Practice address
1 S Prospect St
Burlington, VT 05401-3456
Phone
(802) 847-4560
Fax
(802) 847-8747
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 042.0010844 VT Primary

Addresses

Primary practice location

1 S Prospect St
Burlington, VT 05401-3456

Mailing address

71 Elk LN
Williston, VT 05495-4412
Phone (802) 878-2383

Other identifiers 2

IdentifierTypeStateIssuer
1010931MedicaidVT
02657289MedicaidVT

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041105000733 VT Practitioner - Psychiatry 2062496110 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Albany Medical College of Union University, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Vermont Medical Center IncGroup PAC ID 3779491071, 1,208 clinicians

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 Hospital, Burlington, VT, CCN 470003

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042.0010844VTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Vermont Medical Center Inc Psychiatry CurrentSince Aug 17, 2021 Accepting new patients
University of Vermont Medical Center Inc CurrentSince Jan 15, 2025 Accepting new patients
Central Vermont Medical Center Inc Psychiatry CurrentSince Aug 17, 2021 Accepting new patients
University of Vermont Medical Center Inc Past Accepting new patients

Locations

130 Fisher Rd
Barre, VT 05641
Phone (802) 371-4235

130 Fisher Rd
Berlin, VT 05602
Phone (802) 225-5820

130 Fisher Rd
#C
Berlin, VT 05602
Phone (802) 225-5400

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

Interoperability endpoints

  • Direct secure messaging: jkoutras426081@direct.uvmhealth.org

Organizations & group practices 4

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 1

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1528154697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 ELK LN",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054954412",
            "telephone_number": "802-878-2383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S PROSPECT ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054013456",
            "telephone_number": "802-847-4560",
            "fax_number": "802-847-8747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUTRAS",
        "first_name": "JOHN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VT",
            "license": "042.0010844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010931",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02657289",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.