NPIMap

Individual provider Active NPI

Ankit Gor

  • Dermatology Physician
  • Burlington, VT
National Provider Identifier
1790196525
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
042.0014118 Issued in VT
Practice address
111 Colchester Ave
Burlington, VT 05401
Phone
(802) 847-4570
NPI assigned
May 14, 2014
Last updated
Aug 28, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 295329 NY
Dermatology Physician 207N00000X 042.0014118 VT Primary

Addresses

Primary practice location

111 Colchester Ave
Burlington, VT 05401

Mailing address

111 Colchester Ave
Burlington, VT 05401-1473

Other practice location 1

214 Cornelia St Ste 103
Plattsburgh, NY 12901-2332
Phone (518) 562-7771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, VT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180921002953 NY Practitioner - Dermatology 1456624139 Reassigns benefits to 1 organization
I20180924002372 VT Practitioner - Dermatology 1456624139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

75 Beekman St
Plattsburgh, NY 12901-1438
Phone (518) 561-2000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision13
Removal of skin lesions527
Removal or shaving of skin growth1-10
Skin biopsy299

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
295329NYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Champlain Valley Physicians Hospital Medical Center Dermatology CurrentSince Sep 1, 2018 Accepting new patients
University of Vermont Medical Center Inc CurrentSince Sep 1, 2018 Accepting new patients

Locations

214 Cornelia St
Ste 103
Plattsburgh, NY 12901
Phone (518) 314-3070

75 Beekman St
Plattsburgh, NY 12901
Phone (518) 562-7100

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

Interoperability endpoints

  • Direct secure messaging: agor164976@direct.uvmhealth.org

Organizations & group practices 2

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1790196525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "05401",
            "telephone_number": "802-847-4570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "214 Cornelia St Ste 103",
            "address_purpose": "LOCATION",
            "city": "Plattsburgh",
            "state": "NY",
            "postal_code": "129012332",
            "country_code": "US",
            "telephone_number": "518-562-7771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOR",
        "first_name": "ANKIT",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-14",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "295329",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VT",
            "license": "042.0014118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.