NPIMap

Individual provider Active NPI

Gregory Lawrence Ehle, MMSC, PA-C

  • Medical Physician Assistant
  • Burlington, VT
National Provider Identifier
1861400665
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0550030643 Issued in VT
Practice address
111 Colchester Ave
McClure 1 Cardiology
Burlington, VT 05401-1473
Phone
(802) 847-3352
Fax
(802) 847-8818
NPI assigned
Aug 4, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0550030643 VT Primary

Addresses

Primary practice location

111 Colchester Ave
McClure 1 Cardiology
Burlington, VT 05401-1473

Mailing address

439 Big Hollow Rd
Starksboro, VT 05487-7273
Phone (802) 453-3919

Other identifiers 1

IdentifierTypeStateIssuer
1009842MedicaidVT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080927000072 VT Practitioner - Physician Assistant 1759458169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

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

118 Tilley Dr
South Burlington, VT 05403-4450

62 Tilley Dr
South Burlington, VT 05403-4407

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
000928CTMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc CurrentSince Jul 2, 2003 Accepting new patients
Hospital of Saint Raphael Past Accepting new patients
Fletcher Allen Health Care Inc Past Accepting new patients

Locations

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

111 Colchester Ave
#1
Burlington, VT 05401
Phone (802) 847-3734

118 Tilley Dr
Ste 102
South Burlington, VT 05403
Phone (802) 847-4600

62 Tilley Dr
Ste 101
South Burlington, VT 05403
Phone (802) 847-4514

Interoperability endpoints

  • Direct secure messaging: gehle10667@direct.uvmhealth.org

Organizations & group practices 3

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 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1861400665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "439 BIG HOLLOW RD",
            "city": "STARKSBORO",
            "state": "VT",
            "postal_code": "054877273",
            "telephone_number": "802-453-3919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "address_2": "MCCLURE 1 CARDIOLOGY",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-3352",
            "fax_number": "802-847-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHLE",
        "first_name": "GREGORY",
        "middle_name": "LAWRENCE",
        "name_prefix": "Prof.",
        "credential": "MMSC, PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VT",
            "license": "0550030643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1009842",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.