Kimberly A Hageman, M.D.
Individual provider Active NPI Family Medicine Physician · Milton, VT
NPI 1720002504 · NPPES record last updated Apr 22, 2010
Key facts
- NPI
- 1720002504
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 0420010036 (VT)
- Practice address
- 28 Centre Dr
Milton, VT 05468-3104 - Phone
- (802) 847-4322
- NPI assigned
- Jul 26, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1998
- 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)
1 S Prospect St
Burlington, VT 05401-3456
Phone (802) 847-0000
111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000
Hospital & facility affiliations
- Uvmhn Home Health and Hospice
- Univ. of Vermont - Fletcher Allen Health Care
- Northwestern Medical Center Inc
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Skin biopsy | 1-10 |
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 |
|---|---|---|---|---|
| I20080917000342 | VT | Practitioner - Family Practice | 2163599184 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0420010036 | VT | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Vermont Medical Center Inc | Family Medicine | Current |
Accepting new patients |
| Fletcher Allen Health Care Inc | Past | Accepting new patients |
Locations
1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531
28 Centre Dr
Milton, VT 05468
Phone (802) 847-4322
Interoperability endpoints
- khageman3880@direct.uvmhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0420010036 | VT | Yes |
Addresses
Primary practice location
28 Centre Dr
Milton, VT 05468-3104
Mailing address
28 Centre Dr
Milton, VT 05468-3104
Phone (802) 847-4322
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1008074 | Medicaid | VT | |
| 02176676 | Medicaid | NY |
Other providers in Milton, VT
- Preston Alexander Graham
- Granite Pharmacy Inc.
- Zachary Robert Grenier
- Katrina Alison Groseclose
- Andrew M Gross
- Cortney Lynn Hamel
- Caroline Mae Hazapis
- Bryant D Hazelton
- Health Conscious, Inc.
- Hope and Resilience Therapy, LLC
All providers in Milton, VT · Family Medicine 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 Apr 22, 2010. 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.