Individual provider Active NPI

Geraldine Oppedisano, PH.D

  • Psychologist
  • South Burlington, VT
National Provider Identifier
1992916514
Registry record updated Oct 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
855 Issued in VT
Practice address
PO Box 9278
South Burlington, VT 05407-9278
Phone
(802) 660-2939
NPI assigned
May 25, 2007
Last updated
Oct 13, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 855 VT Primary

Addresses

Primary practice location

PO Box 9278
South Burlington, VT 05407-9278

Mailing address

166 Battery St
Burlington, VT 05401-5283
Phone (802) 660-2939

Other identifiers 1

IdentifierTypeStateIssuer
OPVN3939MedicaidVT

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060313000440 VT Practitioner - Clinical Psychologist 8224045489 Practice locations: South Burlington, VT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

110 Patchen Rd
South Burlington, VT 05403-5785
Phone (802) 660-2939

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507852800000",
    "number": "1992916514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 BATTERY ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015283",
            "telephone_number": "802-660-2939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 9278",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054079278",
            "telephone_number": "802-660-2939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPPEDISANO",
        "first_name": "GERALDINE",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2017-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VT",
            "license": "855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OPVN3939",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Burlington, VT

Sources for this page

Verify at the official NPI Registry.