Individual provider Active NPI

Anne Elizabeth Klein, PA-C

  • Physician Assistant
  • Burlington, VT
National Provider Identifier
1962479683
Registry record updated Jan 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
055-0030805 Issued in VT
Practice address
111 Colchester Ave
Dermatology Outpatient Clinic, 5TH Floor
Burlington, VT 05401-1473
Phone
(802) 847-4570
Fax
(802) 847-3364
NPI assigned
Mar 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 055-0030805 VT Primary

Addresses

Primary practice location

111 Colchester Ave
Dermatology Outpatient Clinic, 5TH Floor
Burlington, VT 05401-1473

Mailing address

111 Colchester Ave
Dermatology Outpatient Clinic, 5TH Floor
Burlington, VT 05401-1473
Phone (802) 847-4570

Other identifiers 1

IdentifierTypeStateIssuer
9000318MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070219000672 VT Practitioner - Physician Assistant 0345234134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 S Prospect St
Burlington, VT 05401-3456
Phone (802) 847-0000

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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
055-0030805VTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc CurrentSince Jan 8, 2007 Accepting new patients
Fletcher Allen Health Care Inc Past Accepting new patients

Locations

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

111 Colchester Ave
Fl 5
Burlington, VT 05401
Phone (802) 847-3072

Interoperability endpoints

  • Direct secure messaging: aklein10756@direct.uvmhealth.org

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231891200000",
    "number": "1962479683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "address_2": "DERMATOLOGY OUTPATIENT CLINIC, 5TH FLOOR",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-4570",
            "fax_number": "802-847-3364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "address_2": "DERMATOLOGY OUTPATIENT CLINIC, 5TH FLOOR",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-4570",
            "fax_number": "802-847-3364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "ANNE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-01",
        "last_updated": "2009-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "055-0030805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000318",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.