Richard D Edelstein, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

420007067 Issued in VT

Practice address

154 Duchess Street
Newport, VT 05855-0724

Phone

(802) 334-6744

Fax

(802) 334-7450

NPI assigned

Dec 8, 2006

Last updated

Apr 30, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Matrix Health Systems P.C.

  • Clinical Psychologist
  • Burlington, VT
  • NPI 1104872712
  NPD (past)

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335744000000",
    "number": "1710047105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 724",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "058550724",
            "telephone_number": "802-334-6744",
            "fax_number": "802-334-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 DUCHESS STREET",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "058550724",
            "telephone_number": "802-334-6744",
            "fax_number": "802-334-7450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDELSTEIN",
        "first_name": "RICHARD",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2012-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VT",
            "license": "420007067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "VT508401",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005084",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donald D Dahlin DDS PLC
• Colleen Lafleur Doty, ARRT (R)(M)(CT) CIIP
• Alice Pitman Drown, MA, LCMHC
• Tamsin Melodie Durand, M.D.
• Margot Eastman, LCMHC
• Jennifer Rogow Edlund, ND
• Heidi Eichenberger
• Steven Eldred
• Enlightened Path Counseling Services, LLC
• Lisa Nicole Erwin-Davidson, M.S., CCC

• Psychiatry Physician in Newport, VT
• Providers in Newport, VT by specialty
• Psychiatry Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.