Northwest Medical Surgical Associates Inc
Organization Active NPI Specialist · St Albans, VT
NPI 1801981964 · NPPES record last updated Nov 29, 2012
Key facts
- NPI
- 1801981964
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- 042-0007703 (VT)
- Legal business name
- NORTHWEST MEDICAL SURGICAL ASSOCIATES INC
- Practice address
- 148 Fairfield Street
St Albans, VT 05478 - Phone
- (802) 524-2168
- Fax
- (802) 524-0411
- NPI assigned
- Oct 4, 2006
- Organization subpart
- No
Authorized official
- Name
- Stephen R Payne, M.D.
- Title
- President
- Phone
- (802) 524-2168
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080114000303 | VT | Part B Supplier - Clinic/Group Practice | 8426139692 |
Receives reassigned benefits from 1 practitioner Practice locations: St Albans, VT |
National Provider Directory
Locations
148 Fairfield St
Saint Albans, VT 05478
Phone (802) 524-2168
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | 042-0007703 | VT | Yes |
Addresses
Primary practice location
148 Fairfield Street
St Albans, VT 05478
Mailing address
PO Box 166
148 Fairfield Street
Saint Albans, VT 05478-0166
Phone (802) 524-2168
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28637 | Other | VT | BLUE CROSS BLUE SHIELD |
Other providers in St Albans, VT
- Steven Bruce North
- Northern Valley Eyecare, Inc.
- Northern Vermont Dermatology, PLC
- Northwest Chiropractic PLLC
- Northwest Hearing Services, PC
- Northwest Radiology Associates P C
- Northwestern Counseling & Support Services
- Northwestern Counseling & Support Services
- Northwestern Counseling & Support Services
- Northwestern Counseling & Support Services Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2012. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.