Jolanta Teresa Amblo, M.D.
Individual provider Active NPI Internal Medicine Physician · Barre, VT
NPI 1962865980 · NPPES record last updated Aug 20, 2019
Key facts
- NPI
- 1962865980
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 042-0014472 (VT)
- Practice address
- 225 S Main St
Barre, VT 05641-4881 - Phone
- (802) 479-3302
- Fax
- (802) 225-5720
- NPI assigned
- Mar 29, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northwestern Medical Center Inc
Practice addresses (Care Compare)
133 Fairfield St
Saint Albans, VT 05478-1726
Hospital & facility affiliations
- Northwestern Medical Center Inc
- Univ. of Vermont - Fletcher Allen Health Care
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190920000552 | VT | Practitioner - Internal Medicine | 3870884240 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042-0014472 | VT | MD | Internal Medicine Physician |
| 63491 | CT | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwestern Medical Center, Inc. | Current | Accepting new patients | |
| Northwestern Medical Center, Inc | Current |
Accepting new patients | |
| Central Vermont Medical Center Inc | Internal Medicine | Current |
Accepting new patients |
| Central Vermont Medical Center Inc | Internal Medicine | Current |
Accepting new patients |
| Northwestern Medical Center, Inc. | Current |
Accepting new patients | |
| Northwestern Medical Center Inc | Current |
Accepting new patients | |
| Northwestern Medical Center, Inc. | Current | Accepting new patients | |
| Northwestern Medical Center Inc | Past | Accepting new patients |
Locations
225 S Main St
Barre, VT 05641
Phone (802) 476-9242
130 Fisher Rd
Barre, VT 05641
Phone (802) 371-4235
77 Vine St
Barre, VT 05641
Phone (802) 225-1266
130 Fisher Rd
#C
Berlin, VT 05602
Phone (802) 225-5400
3 Crest Rd
Saint Albans, VT 05478
Phone (802) 524-4554
133 Fairfield St
Saint Albans, VT 05478
Phone (802) 524-1227
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BJEJDD/Endpoint/BJEJDD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 63491 | CT | |
| Hospitalist Physician | 208M00000X | 63491 | CT | |
| Internal Medicine Physician | 207R00000X | 042-0014472 | VT | Yes |
Addresses
Primary practice location
225 S Main St
Barre, VT 05641-4881
Mailing address
44 Franks Way
Shelburne, VT 05482-7144
Other practice location 1
24 Hospital Ave
Danbury, CT 06810-6099
Phone (203) 739-6612
Other providers in Barre, VT
- Lynne Julia Addiego
- Jennifer S Albert
- Beverly Susan Allen
- Jason Allen
- Nicholas Joseph Alvarez del Castillo
- American Current Care, P.a.
- Katherine Amey
- David Angstreich
- Jessica L Anthony
- Eliza W Anti
All providers in Barre, VT · Internal Medicine Physician in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2019. 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.
- Order and Referring (CMS).
- 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.