Individual provider Active NPI

John C Dewitt, MD, PHD

  • Anatomic Pathology & Clinical Pathology Physician
  • Burlington, VT
National Provider Identifier
1588077572
Registry record updated Aug 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
042.0013884 Issued in VT
Practice address
111 Colchester Ave
Burlington, VT 05401
Phone
(802) 847-5121
NPI assigned
Jun 6, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X L-259392 MA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 042.0013884 VT Primary

Addresses

Primary practice location

111 Colchester Ave
Burlington, VT 05401

Mailing address

Massachusetts General Hospital
55 Fruit St.
Boston, MA 02114
Phone (617) 726-2967

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
I20181011001269 VT Practitioner - Pathology 7214155787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Vermont College of Medicine, 2014
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, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
L-259392MAMDAnatomic Pathology & Clinical Pathology Physician
259392MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc Anatomic Pathology & Clinical Pathology CurrentSince Aug 18, 2018 Accepting new patients

Locations

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

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

Interoperability endpoints

  • Direct secure messaging: jdewitt14903@direct.uvmhealth.org

Organizations & group practices 1

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": "1402012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1588077572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MASSACHUSETTS GENERAL HOSPITAL",
            "address_2": "55 FRUIT ST.",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-726-2967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "05401",
            "telephone_number": "802-847-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWITT",
        "first_name": "JOHN",
        "middle_name": "C",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-06",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MA",
            "license": "L-259392",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "VT",
            "license": "042.0013884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.