Active NPI
Jeremy Hassan
- Pediatrics Physician
- Burlington, VT
National Provider Identifier
1902570724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 042.0017988
- Practice address
- 111 Colchester Ave
Burlington, VT 05401-1473 - Phone
- (802) 847-0000
- NPI assigned
- Aug 4, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 332818 | NY | |
| Hospitalist Physician | 208M00000X | 042.0017988 | VT | |
| Pediatrics Physician | 208000000X | 332818 | NY | |
| Pediatrics Physician | 208000000X | 042.0017988 | VT | Primary |
Addresses
Primary practice location
111 Colchester Ave
Burlington, VT 05401-1473
Mailing address
111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000
Other practice location 1
75 Park Ave
Plattsburgh, NY 12901-2557
Phone (518) 562-7710
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VT, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042.0017988 | VT | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Champlain Valley Physicians Hospital Medical Center | Current | Accepting new patients | |
| University of Vermont Medical Center Inc | Pediatrics | Current | Accepting new patients |
| Champlain Valley Physicians Hospital Medical Center | Past | 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
- jhassan596352@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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Burlington, VT
- NPI 1659309615
Pediatrics
-
- Internal Medicine Physician
- Plattsburgh, NY
- NPI 1124189782
-
- General Acute Care Hospital
- Plattsburgh, NY
- NPI 1033270699
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758240000000",
"number": "1902570724",
"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",
"telephone_number": "802-847-0000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 COLCHESTER AVE",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054011473",
"telephone_number": "802-847-0000"
}
],
"practiceLocations": [
{
"address_1": "75 Park Ave",
"address_purpose": "LOCATION",
"city": "Plattsburgh",
"state": "NY",
"postal_code": "129012557",
"country_code": "US",
"telephone_number": "518-562-7710",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HASSAN",
"first_name": "JEREMY",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-04",
"last_updated": "2025-09-19",
"certification_date": "2025-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "NY",
"license": "332818",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "VT",
"license": "042.0017988",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "332818",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VT",
"license": "042.0017988",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.