Michael A D'Amico, MD
Individual provider Active NPI Pediatric Gastroenterology Physician · Burlington, VT
NPI 1790719326 · NPPES record last updated Oct 4, 2013
Key facts
- NPI
- 1790719326
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Gastroenterology Physician 2080P0206X
- License
- 420010871 (VT)
- Practice address
- 111 Colchester Ave
Burlington, VT 05401-1473 - Phone
- (802) 847-8200
- Fax
- (802) 847-8742
- NPI assigned
- Jul 10, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 14
Medicare Care Compare profile
- Specialty
- Pediatric Medicine
- Education
- George Washington University School of Medicine, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- 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
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in VT, NY
- 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 |
|---|---|---|---|---|
| I20050204000775 | VT | Practitioner - Pediatric Medicine |
0749231983 | Reassigns benefits to 1 organization |
| I20250826004121 | NY | Practitioner - Gastroenterology | 0749231983 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 420010871 | VT | MD | Pediatric Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Champlain Valley Physicians Hospital Medical Center | Current |
Accepting new patients | |
| University of Vermont Medical Center Inc | Current |
Accepting new patients |
Locations
75 Beekman St
Plattsburgh, NY 12901
Phone (518) 562-7100
111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415
1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531
Interoperability endpoints
- mdamico10707@direct.uvmhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Gastroenterology Physician | 2080P0206X | 420010871 | VT | Yes |
Addresses
Primary practice location
111 Colchester Ave
Burlington, VT 05401-1473
Mailing address
111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-4488
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1011059 | Medicaid | VT | |
| 01958185 | Medicaid | NY |
Other providers in Burlington, VT
- Megan D'Agostino
- Robert D'Agostino
- Sarah D'Agostino
- Jenifer D'Aiello
- Danielle Robillard D'Amico
- Ruth D'Angelo
- Liana Dagdavaryan
- Manavi Romit Dalal
- Rosemary L Dale
- Emily Dalton
All providers in Burlington, VT · Pediatric Gastroenterology 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 Oct 4, 2013. 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.