Kathryn Leopold
Individual provider Active NPI Obstetrics & Gynecology Physician · South Burlington, VT
NPI 1912901588 · NPPES record last updated Jul 30, 2024
Key facts
- NPI
- 1912901588
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 207916-3 (NY)
- Practice address
- 1775 Williston Rd Ste 110
South Burlington, VT 05403-6491 - Phone
- (802) 735-1252
- NPI assigned
- Jun 10, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
- 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 |
|---|---|---|---|---|
| I20240807003781 | VT | Practitioner - Obstetrics/Gynecology | 5092994905 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 207916-3 | NY | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vermont Gynecology, PC | Current |
Accepting new patients |
Locations
1775 Williston Rd
Ste 110
South Burlington, VT 05403
Phone (800) 530-1140
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 207916-3 | NY | Yes |
Addresses
Primary practice location
1775 Williston Rd Ste 110
South Burlington, VT 05403-6491
Mailing address
1775 Williston Rd Ste 110
South Burlington, VT 05403-6491
Phone (802) 735-1252
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 040426007730 | Other | NY | FIDELIS |
| 557E61 | Other | NY | BLUE CROSS |
| 01766343 | Medicaid | NY | |
| 10022036 | Other | NY | CDPHP |
| 000405203007 | Other | NY | BLUE SHIELD |
| 391213 | Other | NY | MVP |
Other providers in South Burlington, VT
- Mark Lazarovich
- Glory Ledbetter
- Jaime Ann Leduc
- Hyunbin Lee
- Patrick Lemay
- Francois D Letourneau
- Marcia Levine
- Carly Levinson
- Levitate Lifestyle LLC
- Jennifer Ann Levy
All providers in South Burlington, VT · Obstetrics & Gynecology 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 Jul 30, 2024. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.