Individual provider Active NPI

Anusha Devarajan, MBBS

  • Student in an Organized Health Care Education/Training Program
  • Burlington, VT
National Provider Identifier
1639691272
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
111 Colchester Ave
Burlington, VT 05401-1473
Phone
(802) 656-9004
NPI assigned
Jul 14, 2017
Last updated
Oct 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X AZ Primary
Pulmonary Disease Physician 207RP1001X 042.0017550 VT
Sleep Medicine (Internal Medicine) Physician 207RS0012X 4301508986 MI

Addresses

Primary practice location

111 Colchester Ave
Burlington, VT 05401-1473

Mailing address

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 656-9004

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
I20240919002431 VT Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 7214350321 Reassigns benefits to 1 organization
I20240919003259 NY Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 7214350321 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

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

206 Cornelia St
Plattsburgh, NY 12901-2779

75 Beekman St
Plattsburgh, NY 12901-1438
Phone (518) 562-7100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4301508986MIMDSleep Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alice Hyde Medical Center Single Specialty Current Accepting new patients
Champlain Valley Physicians Hospital Medical Center Single Specialty CurrentSince Aug 13, 2024 Accepting new patients
Alice Hyde Medical Center Single Specialty CurrentSince Dec 22, 2024 Accepting new patients
University of Vermont Medical Center Inc Single Specialty CurrentSince Aug 13, 2024 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

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

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

Interoperability endpoints

  • Direct secure messaging: adevarajan594151@direct.uvmhealth.org

Organizations & group practices 5

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 4

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": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1639691272",
    "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": "802-656-9004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-656-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVARAJAN",
        "first_name": "ANUSHA",
        "credential": "MBBS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-14",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": null,
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "VT",
            "license": "042.0017550",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "MI",
            "license": "4301508986",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.