Individual provider Active NPI

Alan R. Massouh, MD

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
National Provider Identifier
1568922151
Registry record updated Feb 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
042.0018520 Issued in VT
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

Updated by the provider on Feb 13, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250829002993 VT Practitioner - Diagnostic Radiology 9830517317 Reassigns benefits to 3 organizations
I20260211001939 NY Practitioner - Diagnostic Radiology 9830517317 Reassigns benefits to 5 organizations

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
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
  • Northwestern Medical Center Inc Hospital, Saint Albans, VT, CCN 470024
  • Central Vermont Medical Center Hospital, Barre, VT, CCN 470001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
340814NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Champlain Valley Physicians Hospital Medical Center CurrentSince Jan 16, 2026 Accepting new patients
Central Vermont Medical Center Inc CurrentSince Dec 22, 2025 Accepting new patients
University of Vermont Medical Center Inc CurrentSince Jul 21, 2025 Accepting new patients
Porter Hospital, Inc CurrentSince Jul 21, 2025 Accepting new patients
Alice Hyde Medical Center CurrentSince Jan 16, 2026 Accepting new patients
Elizabethtown Community Hospital CurrentSince Jan 16, 2026 Accepting new patients
Elizabethtown Community Hospital CurrentSince Jan 16, 2026 Accepting new patients
Alice Hyde Medical Center CurrentSince Jan 16, 2026 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

  • Direct secure messaging: amassouh625984@direct.uvmhealth.org
  • FHIR API: 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.

Hospital & facility affiliations 3

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": "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

Verify at the official NPI Registry.