Individual provider Active NPI

Charles D Maclean, MD

  • Internal Medicine Physician
  • Essex Junction, VT
National Provider Identifier
1619995792
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
420007816 Issued in VT
Practice address
87 Main St
Essex Junction, VT 05452-3234
Phone
(802) 847-8354
NPI assigned
Jul 17, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 420007816 VT Primary

Addresses

Primary practice location

87 Main St
Essex Junction, VT 05452-3234

Mailing address

280 Country LN
Shelburne, VT 05482-6932

Other identifiers 3

IdentifierTypeStateIssuer
42-0007816OtherVTSTATE OF VT LICENSE
0006102MedicaidVT
01096491MedicaidNY

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
I20080812000632 VT Practitioner - Internal Medicine 1658446596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

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

1 S Prospect St
Burlington, VT 05401-5505
Phone (802) 847-0000

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

2 Essex Way
Essex Junction, VT 05452-3394
Phone (802) 847-8354

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
420007816VTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc Internal Medicine CurrentSince Jul 8, 1988 Accepting new patients
Fletcher Allen Health Care Inc Past Accepting new patients

Locations

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

2 Essex Way
Essex Junction, VT 05452
Phone (802) 847-8354

87 Main St
Essex Junction, VT 05452
Phone (802) 404-1350

Interoperability endpoints

  • Direct secure messaging: cmaclean3762@direct.uvmhealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1619995792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 COUNTRY LN",
            "city": "SHELBURNE",
            "state": "VT",
            "postal_code": "054826932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 MAIN ST",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "054523234",
            "telephone_number": "802-847-8354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACLEAN",
        "first_name": "CHARLES",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VT",
            "license": "420007816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF VT LICENSE",
            "identifier": "42-0007816",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006102",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01096491",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Essex Junction, VT

Sources for this page

Verify at the official NPI Registry.