Northeastern Reproductive Medicine PLLC

Organization Active NPI Obstetrics & Gynecology Physician · Colchester, VT

NPI 1982016689 · NPPES record last updated Aug 11, 2014

Key facts

NPI
1982016689
Entity type
Organization (NPI type 2)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
Legal business name
NORTHEASTERN REPRODUCTIVE MEDICINE PLLC
Practice address
105 Westview Road
Suite 302
Colchester, VT 05446-5996
Phone
(802) 363-4935
Fax
(802) 985-2566
NPI assigned
May 29, 2014
Organization subpart
No

Authorized official

Name
Peter Casson, MD
Title
Owner
Phone
(802) 363-4935

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VT

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20140807001693 VT Part B Supplier - Clinic/Group Practice 2365669736 Receives reassigned benefits from 6 practitioners
Practice locations: Colchester, VT

National Provider Directory

Locations

105 Westview Rd
Ste 302
Colchester, VT 05446
Phone (802) 655-8888

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207V00000X Yes
Reproductive Endocrinology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207VE0102X

Addresses

Primary practice location

105 Westview Road
Suite 302
Colchester, VT 05446-5996

Mailing address

105 Westview Road
Suite 302
Colchester, VT 05446-5996
Phone (802) 363-4935

Other providers in Colchester, VT

All providers in Colchester, VT · Obstetrics & Gynecology Physician in Vermont

Sources for this page

Verify at the official NPI Registry.