Northern Vermont Dermatology, PLC

Key facts

NPI: 1922593060
Entity type: Organization (NPI type 2)
Primary specialty: Medical Specialty Clinic/Center 261QM2500X
License: 0420013164 (VT)
Legal business name: NORTHERN VERMONT DERMATOLOGY, PLC
Practice address: 53 Fairfax Rd Ste 2
Saint Albans, VT 05478-4405
Phone: (833) 688-3376
NPI assigned: Jun 29, 2018
Organization subpart: No

Authorized official

Name: Stephanie Dawn Neider NPI 1386678381
Title: Owner
Phone: (833) 688-3376

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 3

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

Stephanie Dawn Neider, M.D. Dermatology Physician · St. Albans, VT · NPI 1386678381

Medicare reassignment NPD Authorized official DERMATOLOGY · VT
Julie Hsiao-Wen Lin, MD Dermatology Physician · Saint Albans, VT · NPI 1063572907

Medicare reassignment NPD DERMATOLOGY · VT
Patricia L. Seal, M.D. Dermatology Physician · South Burlington, VT · NPI 1730273509

NPD (past) DERMATOLOGY

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
47D2252618	Northern Vermont Dermatology 53 Fairfax Rd, Ste 2, St Albans, VT 05478	Certificate of waiver	Feb 13, 2028

Medicare participation

Medicare fee-for-service enrollment: Enrolled in VT

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20181213000915	VT	Part B Supplier - Clinic/Group Practice	4486999836	Receives reassigned benefits from 2 practitioners Practice locations: Saint Albans, VT

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Dermatology Physician Group: 193400000X SINGLE SPECIALTY GROUP	207N00000X
Medical Specialty Clinic/Center	261QM2500X	0420013164	VT	Yes

Addresses

Primary practice location

53 Fairfax Rd Ste 2
Saint Albans, VT 05478-4405

Mailing address

53 Fairfax Rd Ste 2
Saint Albans, VT 05478-4405
Phone (833) 688-3376

Other practice location 1

30 Farrell St Ste 200
South Burlington, VT 05403-6395
Phone (833) 688-3376

Other providers in Saint Albans, VT

All providers in Saint Albans, VT · Medical Specialty Clinic/Center in Vermont

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 23, 2020. 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.
Medicare Care Compare provider data (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.