Nicholas Brenny, PA-C
Individual provider Active NPI Physician Assistant · Colchester, VT
NPI 1730364142 · NPPES record last updated Jul 15, 2024
Key facts
- NPI
- 1730364142
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 055-0030894 (VT)
- Practice address
- 354 Mountain View Dr Ste 300
Colchester, VT 05446-5988 - Phone
- (802) 864-0192
- Fax
- (802) 860-4919
- NPI assigned
- Jan 3, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Green Mountain Dermatology PLLC
Practice addresses (Care Compare)
354 Mountain View Dr
Colchester, VT 05446-5988
Phone (802) 864-0192
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.67 of 100
- Quality
- 80.11
- Improvement activities
- 40
- Cost
- 88.76
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: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080328000249 | VT | Practitioner - Physician Assistant | 9335225549 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9104082 | FL | MD | Medical Physician Assistant |
| 055-0030894 | VT | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Vermont Medical Center Inc | Current |
Accepting new patients |
Locations
111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415
1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 055-0030894 | VT | |
| Medical Physician Assistant | 363AM0700X | PA9104082 | FL | |
| Physician Assistant | 363A00000X | 055-0030894 | VT | Yes |
Addresses
Primary practice location
354 Mountain View Dr Ste 300
Colchester, VT 05446-5988
Mailing address
354 Mountain View Dr Ste 300
Colchester, VT 05446-5988
Phone (802) 864-0192
Other providers in Colchester, VT
- Gayle I Botelho
- Justin Michael Boufford
- Carolyn Bowman Bliek
- Lakshmi Joshi Boyle
- Natalie Rose Bradford
- Kristin S Brewster
- Courtney Joy Brink
- Elizabeth Brown-Higdon
- Cody W Brown
- Jennifer Keller Brown
All providers in Colchester, VT · Physician Assistant 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 15, 2024. 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.