NPIMap

Individual provider Active NPI

Jillian Leigh Brennan, M.D.

  • Hospitalist Physician
  • Burlington, VT
National Provider Identifier
1942520796
Registry record updated Apr 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
042.0012666 Issued in VT
Practice address
617 Riverside Ave
Burlington, VT 05401-1601
Phone
(802) 264-8158
Fax
(802) 860-4313
NPI assigned
Jun 3, 2010
Last updated
Apr 16, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0420012666 VT
Hospitalist Physician 208M00000X 042.0012666 VT Primary

Addresses

Primary practice location

617 Riverside Ave
Burlington, VT 05401-1601

Mailing address

617 Riverside Ave
Burlington, VT 05401-1601
Phone (802) 264-8158

Other identifiers 2

IdentifierTypeStateIssuer
1022382MedicaidVT
P01338829OtherVTRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131223000120 VT Practitioner - Family Practice 1759531783 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Vermont College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Porter Hospital IncGroup PAC ID 1850365180, 116 clinicians

Practice addresses (Care Compare)

115 Porter Dr
Middlebury, VT 05753-8423
Phone (802) 388-4701

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0420012666VTMDFamily Medicine Physician
042.0012666VTMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc Family Medicine CurrentSince Oct 8, 2013 Accepting new patients
Porter Hospital Inc Current Accepting new patients

Locations

130 Fisher Rd
Barre, VT 05641
Phone (802) 371-4235

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

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

115 Porter Dr
Middlebury, VT 05753
Phone (802) 388-4701

1330 Exchange St
Middlebury, VT 05753
Phone (802) 388-6565

Interoperability endpoints

  • Direct secure messaging: jbrennan14883@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429142400000",
    "number": "1942520796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 RIVERSIDE AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011601",
            "telephone_number": "802-264-8158",
            "fax_number": "802-860-4313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 RIVERSIDE AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011601",
            "telephone_number": "802-264-8158",
            "fax_number": "802-860-4313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "JILLIAN",
        "middle_name": "LEIGH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2015-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "0420012666",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VT",
            "license": "042.0012666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022382",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01338829",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.