Individual provider Active NPI

Laura B Vahey, PA

  • Physician Assistant
  • Woodstock, VT
National Provider Identifier
1962484154
Registry record updated Feb 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0550030965 Issued in VT
Practice address
32 Pleasant Street
Woodstock, VT 05091
Phone
(802) 457-3030
Fax
(802) 457-2157
NPI assigned
Nov 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001719 CT
Physician Assistant 363A00000X 0550030965 VT Primary

Addresses

Primary practice location

32 Pleasant Street
Woodstock, VT 05091

Mailing address

289 County Rd
Windsor, VT 05089-9000
Phone (802) 674-7300

Other identifiers 1

IdentifierTypeStateIssuer
001719OtherCTSTATE LICENSE

Other names 1

  • Laura B Desilets Former name

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
I20090527000183 VT Practitioner - Physician Assistant 3375565948 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0550030965VTMDPhysician Assistant
001719CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Windsor Hospital Corporation CurrentSince Aug 24, 2015 Accepting new patients
Windsor Hospital Corporation CurrentSince Aug 24, 2015 Accepting new patients

Locations

289 County Rd
Windsor, VT 05089
Phone (802) 674-7220

32 Pleasant St
Woodstock, VT 05091
Phone (802) 457-3030

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.

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550361600000",
    "number": "1962484154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "289 COUNTY RD",
            "city": "WINDSOR",
            "state": "VT",
            "postal_code": "050899000",
            "telephone_number": "802-674-7300",
            "fax_number": "802-674-7349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 PLEASANT STREET",
            "city": "WOODSTOCK",
            "state": "VT",
            "postal_code": "05091",
            "telephone_number": "802-457-3030",
            "fax_number": "802-457-2157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAHEY",
        "first_name": "LAURA",
        "middle_name": "B",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-15",
        "last_updated": "2019-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "001719",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "0550030965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "001719",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "DESILETS",
            "middle_name": "B",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Woodstock, VT

Sources for this page

Verify at the official NPI Registry.