Individual provider Active NPI

Judy K Tam, M.D.

  • Body Imaging Physician
  • Burlington, VT
National Provider Identifier
1619994498
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Body Imaging PhysicianTaxonomy code 2085B0100X
License
042-0009170 Issued in VT
Practice address
111 Colchester Ave
Department of Radiology
Burlington, VT 05401-1473
Phone
(802) 847-3592
Fax
(802) 847-4822
NPI assigned
Jul 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X 042-0009170 VT Primary

Addresses

Primary practice location

111 Colchester Ave
Department of Radiology
Burlington, VT 05401-1473

Mailing address

113 Terrace Dr
Williston, VT 05495-2135
Phone (802) 879-3468

Other identifiers 1

IdentifierTypeStateIssuer
OVN1225MedicaidVT

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
I20060403000250 VT Practitioner - Diagnostic Radiology 9537177506 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of California, San Francisco School of Medicine, 1988
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
Porter Hospital IncGroup PAC ID 1850365180, shared by 5 NPIs, 116 clinicians

Practice addresses (Care Compare)

1 S Prospect St
Burlington, VT 05401-3456
Phone (802) 847-0000

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

115 Porter Dr
Middlebury, VT 05753-8423
Phone (802) 388-4701

790 College Pkwy
Colchester, VT 05446-3007
Phone (802) 847-0000

82 Catamount Park
Middlebury, VT 05753-1292
Phone (802) 388-7185

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

Practice roles

OrganizationSpecialtyStatusNew patients
Champlain Valley Physicians Hospital Medical Center CurrentSince Mar 11, 2025 Accepting new patients
Porter Hospital Inc Current Accepting new patients
University of Vermont Medical Center Inc Body Imaging CurrentSince Nov 24, 2008 Accepting new patients
Porter Hospital, Inc CurrentSince Nov 8, 2024 Accepting new patients

Locations

75 Beekman St
Plattsburgh, NY 12901
Phone (518) 562-7100

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

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

104 Porter Dr
Middlebury, VT 05753
Phone (802) 388-5682

115 Porter Dr
Middlebury, VT 05753
Phone (802) 388-4701

82 Catamount Park
Middlebury, VT 05753
Phone (802) 388-7185

44 S Main St
Randolph, VT 05060
Phone (802) 728-4441

Interoperability endpoints

  • Direct secure messaging: jtam10391@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": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619994498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 TERRACE DR",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054952135",
            "telephone_number": "802-879-3468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-3592",
            "fax_number": "802-847-4822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAM",
        "first_name": "JUDY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "VT",
            "license": "042-0009170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN1225",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.