Individual provider Active NPI

Paul Foxman, PH.D., INC.

  • Clinical Psychologist
  • Burlington, VT
National Provider Identifier
1679591895
Registry record updated Mar 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0480000185 Issued in VT
Practice address
112 Lake St
Burlington, VT 05401-5284
Phone
(802) 865-3450
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0480000185 VT Primary

Addresses

Primary practice location

112 Lake St
Burlington, VT 05401-5284

Mailing address

112 Lake St
Burlington, VT 05401-5284
Phone (802) 865-3450

Other identifiers 1

IdentifierTypeStateIssuer
0006558MedicaidVT

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050504000484 VT Practitioner - Clinical Psychologist 5092755504

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Vanderbilt University School of Medicine, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

86 Lake St
Burlington, VT 05401-5284

86 N Jefferson Rd
S Burlington, VT 05403-7926

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0480000185VTMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Paul Foxman, PH.D., Inc. Clinical CurrentSince Aug 27, 1999 Accepting new patients

Locations

112 Lake St
Burlington, VT 05401
Phone (802) 999-4739

86 Lake St
Burlington, VT 05401
Phone (802) 862-8595

Organizations & group practices 1

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.

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": "1522108800000",
    "number": "1679591895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 LAKE ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015284",
            "telephone_number": "802-865-3450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 LAKE ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015284",
            "telephone_number": "802-865-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOXMAN",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PH.D., INC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2018-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VT",
            "license": "0480000185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006558",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.