NPIMap

Individual provider Active NPI

Justin M Stinnett-Donnelly, MD

  • Internal Medicine Physician
  • Berlin, VT
National Provider Identifier
1649594656
Registry record updated Dec 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
042.0012639 Issued in VT
Practice address
130 Fisher Rd
Hospitalist Program
Berlin, VT 05602-9516
Phone
(802) 225-1743
Fax
(802) 225-1745
NPI assigned
Mar 19, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2014

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 042.0012639 VT Primary

Addresses

Primary practice location

130 Fisher Rd
Hospitalist Program
Berlin, VT 05602-9516

Mailing address

PO Box 547
CVMC Finance Dept
Barre, VT 05641-0547
Phone (802) 225-1743

Other identifiers 1

IdentifierTypeStateIssuer
1021787MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130802000801 VT Practitioner - Internal Medicine 5092956086 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Vermont College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Porter Hospital IncGroup PAC ID 1850365180, shared by 5 NPIs, 116 clinicians
Central Vermont Medical Center IncGroup PAC ID 9335138817, shared by 4 NPIs, 233 clinicians

Practice addresses (Care Compare)

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

130 Fisher Rd
Barre, VT 05641-9004
Phone (802) 371-4235

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042.0012639VTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Porter Hospital Inc Current Accepting new patients
Central Vermont Medical Center Inc Internal Medicine CurrentSince Jul 1, 2013 Accepting new patients
Central Vermont Medical Center Inc Internal Medicine Current Accepting new patients
Porter Hospital, Inc Internal Medicine CurrentSince Aug 26, 2024 Accepting new patients

Locations

77 Vine St
Barre, VT 05641
Phone (802) 225-1266

130 Fisher Rd
Barre, VT 05641
Phone (802) 371-4235

130 Fisher Rd
Berlin, VT 05602
Phone (802) 225-5820

130 Fisher Rd
#C
Berlin, VT 05602
Phone (802) 225-5400

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

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 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1268956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417651200000",
    "number": "1649594656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "address_2": "CVMC FINANCE DEPT",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056410547",
            "telephone_number": "802-225-1743",
            "fax_number": "802-225-1745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 FISHER RD",
            "address_2": "HOSPITALIST PROGRAM",
            "city": "BERLIN",
            "state": "VT",
            "postal_code": "056029516",
            "telephone_number": "802-225-1743",
            "fax_number": "802-225-1745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINNETT-DONNELLY",
        "first_name": "JUSTIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-19",
        "last_updated": "2014-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VT",
            "license": "042.0012639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021787",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, VT

Sources for this page

Verify at the official NPI Registry.