Pamela Derickson, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

042.0016455 Issued in VT

Practice address

111 Colchester Ave
Burlington, VT 05401-1473

Phone

(802) 847-2345

NPI assigned

Mar 25, 2020

Last updated

Jul 25, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VT, NY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Psychiatry

Education

University of Vermont College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Vermont Medical Center IncGroup PAC ID 3779491071, 1,208 clinicians

Central Vermont Medical Center IncGroup PAC ID 9335138817, 233 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Univ. of Vermont - Fletcher Allen Health Care Hospital, Burlington, VT, CCN 470003
• Central Vermont Medical Center Hospital, Barre, VT, CCN 470001

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pderickson82783@direct.uvmhealth.org

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.

• Central Vermont Medical Center Inc

  • Family Medicine Physician
  • Berlin, VT
  • NPI 1023028784

  Psychiatry

  Medicare reassignment Care Compare group NPD
• University of Vermont Medical Center Inc

  dba Uvm Medical Center

  • Internal Medicine Physician
  • Burlington, VT
  • NPI 1659309615
  Medicare reassignment Care Compare group NPD
• Champlain Valley Physicians Hospital Medical Center

  • Internal Medicine Physician
  • Plattsburgh, NY
  • NPI 1124189782

  Psychiatry

  Medicare reassignment NPD
• University of Vermont Medical Center Inc

  • General Acute Care Hospital
  • Burlington, VT
  • NPI 1568419976
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Central Vermont Medical Center Inc

  • General Acute Care Hospital
  • Berlin, VT
  • NPI 1508845637
  Care Compare affiliation
• University of Vermont Medical Center Inc

  • General Acute Care Hospital
  • Burlington, VT
  • NPI 1568419976
  Care Compare affiliation

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1750918280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 S UNION ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014965",
            "telephone_number": "856-906-5745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERICKSON",
        "first_name": "PAMELA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VT",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VT",
            "license": "042.0016455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lianna Katherine Demko, DPT
• Amy Denis, FNP
• Jan Hendrik Denkmann, M.D.
• Lisa Dennis
• Benjamin Joseph Depo, MD
• Loren Michele Deron
• Adam C Desanctis, D.D.S.
• Claude Deschamps, M.D.
• Chassidy Lynn Deslauriers, R.D
• Nancy J Desrault, MSW LICSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.