Organization Active NPI

Integrated Dermatology of South Burlington, PLLC

  • Dermatology Physician
  • South Burlington, VT
National Provider Identifier
1871199703
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
INTEGRATED DERMATOLOGY OF SOUTH BURLINGTON, PLLC
Practice address
321 Dorset St
South Burlington, VT 05403-6639
Phone
(802) 660-8808
Fax
(802) 660-4310
NPI assigned
Dec 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Authorized official

Name
Robert Benson, MD
Title
Authorized Group Official
Phone
(561) 314-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

321 Dorset St
South Burlington, VT 05403-6639

Mailing address

4700 Exchange CT Ste 110
Boca Raton, FL 33431-4450
Phone (561) 314-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210305000657 VT Part B Supplier - Clinic/Group Practice 3173939766 Receives reassigned benefits from 9 practitioners
Practice locations: South Burlington, VT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
30D0687560Integrated Dermatology of South Burlington321 Dorset St, South Burlington, VT 05403Certificate of waiverSep 30, 2026

National Provider Directory

National Provider Directory

Locations

321 Dorset St
South Burlington, VT 05403
Phone (802) 660-8808

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755043200000",
    "number": "1871199703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 EXCHANGE CT STE 110",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314450",
            "telephone_number": "561-314-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 DORSET ST",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036639",
            "telephone_number": "802-660-8808",
            "fax_number": "802-660-4310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED DERMATOLOGY OF SOUTH BURLINGTON, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-07",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A",
        "authorized_official_last_name": "BENSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "AUTHORIZED GROUP OFFICIAL",
        "authorized_official_telephone_number": "561-314-2000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Burlington, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.