Tracey Sue Maurer, MD
Individual provider Active NPI Obstetrics & Gynecology Physician · Williston, VT
NPI 1689698227 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1689698227
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 042-0010177 (VT)
- Practice address
- 353 Blair Park Rd
Williston, VT 05495-7530 - Phone
- (802) 847-1600
- NPI assigned
- Jul 27, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- University of Vermont Medical Center Inc
Practice addresses (Care Compare)
792 College Pkwy
Colchester, VT 05446-3052
Phone (802) 847-4914
Hospital & facility affiliations
- Univ. of Vermont - Fletcher Allen Health Care
- Northwestern Medical Center Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081021000456 | VT | Practitioner - Obstetrics/Gynecology | 5799843645 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042-0010177 | VT | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Vermont Medical Center Inc | Obstetrics & Gynecology | Current |
Accepting new patients |
Locations
1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531
792 College Pkwy
Ste 101
Colchester, VT 05446
Phone (802) 847-4914
792 College Pkwy
Colchester, VT 05446
Phone (802) 847-0193
353 Blair Park Rd
Williston, VT 05495
Phone (802) 847-1440
Interoperability endpoints
- tmaurer3924@direct.uvmhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 042-0010177 | VT | Yes |
Addresses
Primary practice location
353 Blair Park Rd
Williston, VT 05495-7530
Mailing address
41 Alpine Dr
Jericho, VT 05465-2071
Phone (802) 899-3697
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02128861 | Other | NY | NY MEDICAID |
| 0VN2505 | Medicaid | VT |
NPI Registry JSON
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689698227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 ALPINE DR",
"city": "JERICHO",
"state": "VT",
"postal_code": "054652071",
"telephone_number": "802-899-3697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "353 BLAIR PARK RD",
"city": "WILLISTON",
"state": "VT",
"postal_code": "054957530",
"telephone_number": "802-847-1600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAURER",
"first_name": "TRACEY",
"middle_name": "SUE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "VT",
"license": "042-0010177",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NY MEDICAID",
"identifier": "02128861",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0VN2505",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Williston, VT
- Moriah Constance Manahan
- Stephen E Mann
- Nicholas Paul Marconi
- Jessica Marini
- Martins Foods of South Burlington LLC
- Sarah E Mazur
- Andrew McCanse
- Heidi S McClellan
- McKenzie B McClellan
- Tawnya McDonald
All providers in Williston, VT · Obstetrics & Gynecology Physician in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.