Active NPI
Alan R. Massouh, MD
- Diagnostic Radiology Physician
- Salt Lake City, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 042.0018520
- Practice address
- 30 N 1900 E RM 1A071
Salt Lake City, UT 84132-0002 - Phone
- (801) 581-2868
- NPI assigned
- Mar 21, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 340814 | NY | |
| Diagnostic Radiology Physician | 2085R0202X | 11924132-1205 | UT | |
| Vascular & Interventional Radiology Physician | 2085R0204X | 11924132-1205 | UT | |
| Diagnostic Radiology Physician | 2085R0202X | 042.0018520 | VT | Primary |
Addresses
Primary practice location
30 N 1900 E RM 1A071
Salt Lake City, UT 84132-0002
Mailing address
111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000
Other practice location 1
75 Beekman St
Plattsburgh, NY 12901-1427
Phone (518) 561-2000
Other practice location 2
75 Park St
Elizabethtown, NY 12932
Phone (518) 873-6377
Other practice location 3
130 Fisher Rd
Berlin, VT 05602-9516
Phone (802) 371-4100
Other practice location 4
133 Park St
Malone, NY 12953-1244
Phone (518) 483-3000
Other practice location 5
115 Porter Dr
Middlebury, VT 05753-8423
Phone (802) 388-4430
Other practice location 6
111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VT, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Georgetown University School of Medicine, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
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
- Northwestern Medical Center Inc
- Central Vermont Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 340814 | NY | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Champlain Valley Physicians Hospital Medical Center | Current | Accepting new patients | |
| Central Vermont Medical Center Inc | Current | Accepting new patients | |
| University of Vermont Medical Center Inc | Current | Accepting new patients | |
| Porter Hospital, Inc | Current | Accepting new patients | |
| Alice Hyde Medical Center | Current | Accepting new patients | |
| Elizabethtown Community Hospital | Current | Accepting new patients | |
| Elizabethtown Community Hospital | Current | Accepting new patients | |
| Alice Hyde Medical Center | Current | Accepting new patients | |
| Alice Hyde Medical Center | Past | Accepting new patients |
Locations
969 State Route 11
Moira, NY 12957
Phone (518) 529-7847
75 Beekman St
Plattsburgh, NY 12901
Phone (518) 562-7100
130 Fisher Rd
Berlin, VT 05602
Phone (802) 225-5820
130 Fisher Rd
#C
Berlin, VT 05602
Phone (802) 225-5400
111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415
1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531
115 Porter Dr
Middlebury, VT 05753
Phone (802) 388-4701
82 Catamount Park
Middlebury, VT 05753
Phone (802) 388-7185
104 Porter Dr
Middlebury, VT 05753
Phone (802) 388-5682
Interoperability endpoints
- amassouh625984@direct.uvmhealth.org
- https://fhir-usa.unify.chbase.com/org/elizabe-e663f886
Organizations & group practices 9
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.
-
- Internal Medicine Physician
- Burlington, VT
- NPI 1659309615
-
- Critical Access Hospital
- Malone, NY
- NPI 1114954682
-
- Family Medicine Physician
- Berlin, VT
- NPI 1023028784
-
- Internal Medicine Physician
- Plattsburgh, NY
- NPI 1124189782
-
- General Practice Physician
- Elizabethtown, NY
- NPI 1053656744
-
- Critical Access Hospital
- Elizabethtown, NY
- NPI 1891785184
-
- Family Medicine Physician
- Middlebury, VT
- NPI 1134457013
-
- General Practice Physician
- Malone, NY
- NPI 1568735660
-
- Skilled Nursing Facility
- Malone, NY
- NPI 1356441349
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Berlin, VT
- NPI 1508845637
-
- General Acute Care Hospital
- Saint Albans, VT
- NPI 1386689875
-
- General Acute Care Hospital
- Burlington, VT
- NPI 1568419976
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770940800000",
"number": "1568922151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 COLCHESTER AVE",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054011473",
"telephone_number": "802-847-0000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 N 1900 E RM 1A071",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841320002",
"telephone_number": "801-581-2868"
}
],
"practiceLocations": [
{
"address_1": "75 Beekman St",
"address_purpose": "LOCATION",
"city": "Plattsburgh",
"state": "NY",
"postal_code": "129011427",
"country_code": "US",
"telephone_number": "518-561-2000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "75 Park St",
"address_purpose": "LOCATION",
"city": "Elizabethtown",
"state": "NY",
"postal_code": "12932",
"country_code": "US",
"telephone_number": "518-873-6377",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "130 Fisher Rd",
"address_purpose": "LOCATION",
"city": "Berlin",
"state": "VT",
"postal_code": "056029516",
"country_code": "US",
"telephone_number": "802-371-4100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "133 Park St",
"address_purpose": "LOCATION",
"city": "Malone",
"state": "NY",
"postal_code": "129531244",
"country_code": "US",
"telephone_number": "518-483-3000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "115 Porter Dr",
"address_purpose": "LOCATION",
"city": "Middlebury",
"state": "VT",
"postal_code": "057538423",
"country_code": "US",
"telephone_number": "802-388-4430",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "111 Colchester Ave",
"address_purpose": "LOCATION",
"city": "Burlington",
"state": "VT",
"postal_code": "054011473",
"country_code": "US",
"telephone_number": "802-847-0000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MASSOUH",
"first_name": "ALAN",
"middle_name": "R.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-21",
"last_updated": "2026-02-13",
"certification_date": "2026-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NY",
"license": "340814",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "UT",
"license": "11924132-1205",
"primary": false
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "UT",
"license": "11924132-1205",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "VT",
"license": "042.0018520",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2026; 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.