Active NPI
Samuel O. Seideman, M.D.
- Ophthalmology Physician
- Barre, VT
National Provider Identifier
1609899616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 0420005777
- Practice address
- 58 E View LN
Barre, VT 05641-5317 - Phone
- (802) 223-0822
- Fax
- (802) 229-1353
- NPI assigned
- Jul 25, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 0420005777 | VT | Primary |
Addresses
Primary practice location
58 E View LN
Barre, VT 05641-5317
Mailing address
1065 Gonyeau Rd
Plainfield, VT 05667-9661
Phone (802) 476-7069
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0004657 | Medicaid | VT | |
| 62126974 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0420005777 | VT | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fletcher Allen Health Care Inc | Past | Accepting new patients | |
| University of Vermont Medical Center Inc | Ophthalmology | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Radiation Oncology Physician
- Burlington, VT
- NPI 1619266624
-
- Internal Medicine Physician
- Burlington, VT
- NPI 1659309615
Ophthalmology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609899616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1065 GONYEAU RD",
"city": "PLAINFIELD",
"state": "VT",
"postal_code": "056679661",
"telephone_number": "802-476-7069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "58 E VIEW LN",
"city": "BARRE",
"state": "VT",
"postal_code": "056415317",
"telephone_number": "802-223-0822",
"fax_number": "802-229-1353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEIDEMAN",
"first_name": "SAMUEL",
"middle_name": "O.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "VT",
"license": "0420005777",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0004657",
"state": "VT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "62126974",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Barre, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.