Individual provider Active NPI

Dylan Hershkowitz, MD

  • Psychiatry Physician
  • Shelburne, VT
National Provider Identifier
1922538644
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
042.0017013 Issued in VT
Practice address
145 Pine Haven Shores Rd Ste 1191
Shelburne, VT 05482-7821
Phone
(802) 899-0124
Fax
(855) 268-5333
NPI assigned
Jun 14, 2017
Last updated
Jun 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 323968 NY
Psychiatry Physician 2084P0800X MD17074 RI
Psychiatry Physician 2084P0800X LP04018 RI
Psychiatry Physician 2084P0800X 042.0017013 VT Primary

Addresses

Primary practice location

145 Pine Haven Shores Rd Ste 1191
Shelburne, VT 05482-7821

Mailing address

420 Scrabbletown Rd Ste a
North Kingstown, RI 02852-3638
Phone (401) 258-5419

Other practice location 1

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

Other practice location 2

345 Blackstone Blvd
Providence, RI 02906-4800
Phone (401) 455-6375

Other practice location 3

75 Beekman St
Plattsburgh, NY 12901-1427
Phone (518) 561-2000

Other practice location 4

1170 Pontiac Ave
Cranston, RI 02920-7944
Phone (401) 500-0424

Other practice location 5

130 Fisher Rd
Berlin, VT 05602-9516
Phone (802) 371-4100

Other identifiers 1

IdentifierTypeStateIssuer
MD17074OtherRISTATE MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, VT, NY3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20220804001594 RI Practitioner - Psychiatry 3577836600 Reassigns benefits to 4 organizations
I20230920003632 VT Practitioner - Psychiatry 3577836600 Reassigns benefits to 3 organizations
I20230921002968 NY Practitioner - Psychiatry 3577836600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Vermont College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South County Psychiatry LLCGroup PAC ID 4880021658, 28 clinicians

Practice addresses (Care Compare)

1170 Pontiac Ave
Cranston, RI 02920-7944
Phone (401) 268-5333

145 Pine Haven Shores Rd
Suite 1191
Shelburne, VT 05482-7821
Phone (802) 899-0124

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
323968NYMDPsychiatry Physician
MD17074RIMDPsychiatry Physician
042.0017013VTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South County Psychiatry LLC Psychiatry CurrentSince Nov 23, 2024 Accepting new patients
Central Vermont Medical Center Inc Psychiatry CurrentSince Aug 8, 2023 Accepting new patients
Champlain Valley Physicians Hospital Medical Center Psychiatry CurrentSince Aug 8, 2023 Accepting new patients
Rhode Island Hospital Psychiatry CurrentSince Aug 1, 2022 Accepting new patients
The Miriam Hospital CurrentSince Aug 1, 2022 Accepting new patients
The Miriam Hospital CurrentSince Aug 1, 2022 Accepting new patients
Lifespan Physician Group, Inc. Psychiatry CurrentSince Aug 1, 2022 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Aug 1, 2022 Accepting new patients
University of Vermont Medical Center Inc CurrentSince Aug 8, 2023 Accepting new patients
Rhode Island Hospital CurrentSince Aug 1, 2022 Accepting new patients

Locations

75 Beekman St
Plattsburgh, NY 12901
Phone (518) 562-7100

1170 Pontiac Ave
Cranston, RI 02920
Phone (401) 500-0424

420 Scrabbletown Rd
Ste A
North Kingstown, RI 02852
Phone (401) 268-5333

47 Danielson Pike
North Scituate, RI 02857
Phone (401) 258-5419

146 W River St
Ste 11C
Providence, RI 02904
Phone (401) 606-3000

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

345 Blackstone Blvd
Providence, RI 02906
Phone (401) 455-6375

593 Eddy St
Providence, RI 02903

593 Eddy St
Ste 9B
Providence, RI 02903
Phone (401) 444-5280

130 Fisher Rd
Berlin, VT 05602
Phone (802) 225-5820

130 Fisher Rd
#C
Berlin, VT 05602
Phone (802) 225-5400

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

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

145 Pine Haven Shores Rd
Ste 1191
Shelburne, VT 05482
Phone (401) 268-5333

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1922538644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 SCRABBLETOWN RD STE A",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028523638",
            "telephone_number": "401-258-5419",
            "fax_number": "855-268-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 PINE HAVEN SHORES RD STE 1191",
            "city": "SHELBURNE",
            "state": "VT",
            "postal_code": "054827821",
            "telephone_number": "802-899-0124",
            "fax_number": "855-268-5333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Colchester Ave",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054011473",
            "country_code": "US",
            "telephone_number": "802-847-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "345 Blackstone Blvd",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029064800",
            "country_code": "US",
            "telephone_number": "401-455-6375",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "75 Beekman St",
            "address_purpose": "LOCATION",
            "city": "Plattsburgh",
            "state": "NY",
            "postal_code": "129011427",
            "country_code": "US",
            "telephone_number": "518-561-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1170 Pontiac Ave",
            "address_purpose": "LOCATION",
            "city": "Cranston",
            "state": "RI",
            "postal_code": "029207944",
            "country_code": "US",
            "telephone_number": "401-500-0424",
            "fax_number": "855-268-5333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 Fisher Rd",
            "address_purpose": "LOCATION",
            "city": "Berlin",
            "state": "VT",
            "postal_code": "056029516",
            "country_code": "US",
            "telephone_number": "802-371-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERSHKOWITZ",
        "first_name": "DYLAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-14",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "323968",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "RI",
            "license": "MD17074",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "RI",
            "license": "LP04018",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VT",
            "license": "042.0017013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "MD17074",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelburne, VT

Sources for this page

Verify at the official NPI Registry.