NPIMap

Individual provider Active NPI

Jolanta Teresa Amblo, M.D.

  • Internal Medicine Physician
  • Barre, VT
National Provider Identifier
1962865980
Registry record updated Aug 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
042-0014472 Issued in VT
Practice address
225 S Main St
Barre, VT 05641-4881
Phone
(802) 479-3302
Fax
(802) 225-5720
NPI assigned
Mar 29, 2016
Last updated
Aug 20, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 63491 CT
Hospitalist Physician 208M00000X 63491 CT
Internal Medicine Physician 207R00000X 042-0014472 VT Primary

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

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
I20190920000552 VT Practitioner - Internal Medicine 3870884240 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Center IncGroup PAC ID 5496714313, shared by 4 NPIs, 105 clinicians

Practice addresses (Care Compare)

133 Fairfield St
Saint Albans, VT 05478-1726

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63491CTMDInternal Medicine Physician
042-0014472VTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Center, Inc CurrentSince Dec 7, 2023 Accepting new patients
Central Vermont Medical Center Inc Internal Medicine CurrentSince Aug 1, 2019 Accepting new patients
Northwestern Medical Center, Inc. Current Accepting new patients
Northwestern Medical Center, Inc. Current Accepting new patients
Northwestern Medical Center Inc CurrentSince Dec 7, 2023 Accepting new patients
Northwestern Medical Center, Inc. CurrentSince Dec 7, 2023 Accepting new patients
Central Vermont Medical Center Inc Internal Medicine CurrentSince Aug 1, 2019 Accepting new patients
Northwestern Medical Center Inc Past Accepting new patients

Locations

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

225 S Main St
Barre, VT 05641
Phone (802) 476-9242

77 Vine St
Barre, VT 05641
Phone (802) 225-1266

130 Fisher Rd
#C
Berlin, VT 05602
Phone (802) 225-5400

133 Fairfield St
Saint Albans, VT 05478
Phone (802) 524-1227

3 Crest Rd
Saint Albans, VT 05478
Phone (802) 524-4554

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BJEJDD/Endpoint/BJEJDD

Organizations & group practices 8

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 2

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": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1962865980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 FRANKS WAY",
            "city": "SHELBURNE",
            "state": "VT",
            "postal_code": "054827144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 S MAIN ST",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056414881",
            "telephone_number": "802-479-3302",
            "fax_number": "802-225-5720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24 Hospital Ave",
            "address_purpose": "LOCATION",
            "city": "Danbury",
            "state": "CT",
            "postal_code": "068106099",
            "country_code": "US",
            "telephone_number": "203-739-6612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMBLO",
        "first_name": "JOLANTA",
        "middle_name": "TERESA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "63491",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "63491",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VT",
            "license": "042-0014472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barre, VT

Sources for this page

Verify at the official NPI Registry.