| Carlos G. Otis Health Care Center, Inc. | |
|
185 Grafton Rd. Townshend VT 05353 | |
| (802) 365-4331 | |
| Not Available |
| Full Name | Carlos G. Otis Health Care Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 185 Grafton Rd., Townshend, Vermont |
| Authorized Official Name and Position | Stephen Alan Brown (CFO) |
| Authorized Official Contact | 8023653601 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carlos G. Otis Health Care Center, Inc. Po Box 216 Townshend VT 05353-0216 Ph: (802) 365-4331 | Carlos G. Otis Health Care Center, Inc. 185 Grafton Rd. Townshend VT 05353 Ph: (802) 365-4331 |
| NPI Number | 1124049960 |
|---|---|
| Provider Enumeration Date | 07/21/2006 |
| Last Update Date | 06/06/2020 |
| Medicare PECOS PAC ID | 6002726387 |
|---|---|
| Medicare Enrollment ID | O20040802001147 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124049960 | NPI | - | NPPES |
| OVN0834 | Medicaid | VT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Ronald D Vallario |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659393064 PECOS PAC ID: 9638141328 Enrollment ID: I20040817001182 |
| Provider Name | George P Terwilliger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265515910 PECOS PAC ID: 0941217608 Enrollment ID: I20060321000562 |
| Provider Name | Craig Goldberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205862372 PECOS PAC ID: 3375551856 Enrollment ID: I20060324000208 |
| Provider Name | Moss Linder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134119514 PECOS PAC ID: 3870509631 Enrollment ID: I20080724000053 |
| Provider Name | Elizabeth K Linder |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003806480 PECOS PAC ID: 7810060738 Enrollment ID: I20080724000617 |
| Provider Name | Kimona Alin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326038878 PECOS PAC ID: 8022170216 Enrollment ID: I20081223000037 |
| Provider Name | Timothy Philip Shafer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053301721 PECOS PAC ID: 2466363270 Enrollment ID: I20090112000596 |
| Provider Name | Ewa Arnold |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235360462 PECOS PAC ID: 5799936795 Enrollment ID: I20121126000347 |
| Provider Name | Benjamin Warren Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760867956 PECOS PAC ID: 5092022954 Enrollment ID: I20150910000719 |
| Provider Name | Jeremy Morrison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154769685 PECOS PAC ID: 5193023950 Enrollment ID: I20160920000966 |
| Provider Name | David Mccormack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619420346 PECOS PAC ID: 6002103843 Enrollment ID: I20160922001605 |
| Provider Name | Steven Lengle |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861483182 PECOS PAC ID: 4789652397 Enrollment ID: I20170317000211 |
| Provider Name | David M Moon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548213812 PECOS PAC ID: 2769476555 Enrollment ID: I20170317000558 |
| Provider Name | Yair Chaya |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225356934 PECOS PAC ID: 7810270279 Enrollment ID: I20170317000959 |
| Provider Name | Bruce Reiner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447235783 PECOS PAC ID: 7911008602 Enrollment ID: I20170317001110 |
| Provider Name | Michael S Allen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083662654 PECOS PAC ID: 8527964337 Enrollment ID: I20170317001294 |
| Provider Name | Karen S Caldemeyer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679511356 PECOS PAC ID: 9931003506 Enrollment ID: I20170317001392 |
| Provider Name | Dawn N Delavallade |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750445086 PECOS PAC ID: 9739124249 Enrollment ID: I20170320000045 |
| Provider Name | Albert Ybasco |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215900162 PECOS PAC ID: 3971587643 Enrollment ID: I20170320000654 |
| Provider Name | Charles Henry |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134211931 PECOS PAC ID: 6901820620 Enrollment ID: I20170320000821 |
| Provider Name | Larry Kessler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033197652 PECOS PAC ID: 5698666501 Enrollment ID: I20170320000863 |
| Provider Name | Peter B Zelinka |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154458545 PECOS PAC ID: 5698869949 Enrollment ID: I20170320000875 |
| Provider Name | Alan J Kopp |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851349112 PECOS PAC ID: 9739251034 Enrollment ID: I20170320001330 |
| Provider Name | Gregory Kenyherz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417953795 PECOS PAC ID: 1759462625 Enrollment ID: I20170320001458 |
| Provider Name | Jeffrey G Zorn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750366498 PECOS PAC ID: 1052406832 Enrollment ID: I20170320001578 |
| Provider Name | William Zinn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912984238 PECOS PAC ID: 2062460694 Enrollment ID: I20170320002062 |
| Provider Name | Sam Siu Cheng |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467430082 PECOS PAC ID: 5991696882 Enrollment ID: I20170320002138 |
| Provider Name | Benjamin Strong |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205811569 PECOS PAC ID: 8426048232 Enrollment ID: I20170320002270 |
| Provider Name | Donald T. Nicell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689679631 PECOS PAC ID: 2769458819 Enrollment ID: I20170321000058 |
| Provider Name | Kimberly J Burkholz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417914169 PECOS PAC ID: 4688686496 Enrollment ID: I20170321000285 |
| Provider Name | Scott Kerns |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336137165 PECOS PAC ID: 9931145331 Enrollment ID: I20170322000581 |
| Provider Name | Michael Nissenbaum |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356328975 PECOS PAC ID: 8325083546 Enrollment ID: I20170324001035 |
| Provider Name | Kevin Michael Mcdonnell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578548533 PECOS PAC ID: 1052309101 Enrollment ID: I20170327001717 |
| Provider Name | Jennifer Bryant |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396751426 PECOS PAC ID: 2163412396 Enrollment ID: I20170330000091 |
| Provider Name | Talitha S Travis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891955803 PECOS PAC ID: 4082856281 Enrollment ID: I20170815001953 |
| Provider Name | Dietrich W.l. Schultze |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922192459 PECOS PAC ID: 8325939499 Enrollment ID: I20170821000292 |
| Provider Name | Alison Haimes |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669459392 PECOS PAC ID: 9032304480 Enrollment ID: I20170901001253 |
| Provider Name | Andrew Edward Semegram |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164943692 PECOS PAC ID: 5991078024 Enrollment ID: I20170912000220 |
| Provider Name | Anne Alexander Brewer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932118577 PECOS PAC ID: 3173629128 Enrollment ID: I20180131000867 |
| Provider Name | Marc-olivier Ratte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891100442 PECOS PAC ID: 8527313600 Enrollment ID: I20180613000896 |
| Provider Name | Surinder Rai |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275950925 PECOS PAC ID: 3971814955 Enrollment ID: I20181119000787 |
| Provider Name | Scott C Mcdonald |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1841604642 PECOS PAC ID: 0446519573 Enrollment ID: I20181126003506 |
| Provider Name | Wendy E Zimmer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568420149 PECOS PAC ID: 8820195159 Enrollment ID: I20190313002847 |
| Provider Name | John K Chang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720063852 PECOS PAC ID: 0042248486 Enrollment ID: I20190610001978 |
| Provider Name | Donn Kirk Beeson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740495654 PECOS PAC ID: 6901957448 Enrollment ID: I20190708001708 |
| Provider Name | Serge Somrov |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346462629 PECOS PAC ID: 7012017957 Enrollment ID: I20190709000834 |
| Provider Name | Summer A Burch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184276842 PECOS PAC ID: 0042547945 Enrollment ID: I20190815001841 |
| Provider Name | Christopher S Lawton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285673293 PECOS PAC ID: 1052375508 Enrollment ID: I20200211002693 |
| Provider Name | Cynthia L Howes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326126350 PECOS PAC ID: 4587093471 Enrollment ID: I20200327001375 |
| Provider Name | Duane Charles Wilson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780664664 PECOS PAC ID: 0345137907 Enrollment ID: I20200504001852 |
| Provider Name | Meredith L Kenyon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134421928 PECOS PAC ID: 7113297227 Enrollment ID: I20201203000790 |
| Provider Name | David Ives |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336127687 PECOS PAC ID: 2961710900 Enrollment ID: I20210122000290 |
| Provider Name | Peggy Rouleau |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578542585 PECOS PAC ID: 7113055740 Enrollment ID: I20210511001171 |
| Provider Name | Jennifer Leigh Zweig |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891937017 PECOS PAC ID: 8022159334 Enrollment ID: I20211004003263 |
| Provider Name | Juliette Carr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073285730 PECOS PAC ID: 5193113249 Enrollment ID: I20211022001690 |
| Provider Name | Carlos Enrique Encarnacion |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679521686 PECOS PAC ID: 6901847029 Enrollment ID: I20220210001625 |
| Provider Name | Gregg Peter Sydow |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619157609 PECOS PAC ID: 6002057296 Enrollment ID: I20220302001843 |
| Provider Name | Naoki O Murai |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285052217 PECOS PAC ID: 1052626108 Enrollment ID: I20220303000061 |
| Provider Name | Benjamin William Woodard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750673315 PECOS PAC ID: 8527285832 Enrollment ID: I20220407000599 |
| Provider Name | Elise Kathleen Sawyer Kraus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174276067 PECOS PAC ID: 4183001449 Enrollment ID: I20220507000140 |
| Provider Name | Richard C Wilson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134100589 PECOS PAC ID: 3678584364 Enrollment ID: I20220610000993 |
| Provider Name | Jill Wruble |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396717666 PECOS PAC ID: 3173515632 Enrollment ID: I20220714001753 |
| Provider Name | Shwan Kim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417901877 PECOS PAC ID: 0345258976 Enrollment ID: I20220830001992 |
| Provider Name | Wyll T Everett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316407125 PECOS PAC ID: 4688907033 Enrollment ID: I20220916002523 |
| Provider Name | Tamara A Trella |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871708438 PECOS PAC ID: 5193858504 Enrollment ID: I20230613001437 |
| Provider Name | Mary Margaret Alfidi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992814396 PECOS PAC ID: 7315971504 Enrollment ID: I20240321002108 |
| Provider Name | Robin Gwaltney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639369259 PECOS PAC ID: 2062553647 Enrollment ID: I20240321002240 |
| Provider Name | Thomas Gallagher |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215904677 PECOS PAC ID: 9739117367 Enrollment ID: I20240321002496 |
| Provider Name | David Sarver |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750624144 PECOS PAC ID: 7416273883 Enrollment ID: I20240322000879 |
| Provider Name | Robert Watson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376049676 PECOS PAC ID: 7618221755 Enrollment ID: I20240322001180 |
| Provider Name | Demetrice Davis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962710780 PECOS PAC ID: 0446406573 Enrollment ID: I20240322001766 |
| Provider Name | Neda Yagan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366466112 PECOS PAC ID: 2466530035 Enrollment ID: I20240322002166 |
| Provider Name | Shailendri Eswar-rao Philip |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1588697924 PECOS PAC ID: 5092898593 Enrollment ID: I20240322003350 |
| Provider Name | Jason Mallow |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235423187 PECOS PAC ID: 0749527984 Enrollment ID: I20240322003663 |
| Provider Name | Amanda Lindsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669845277 PECOS PAC ID: 8729377247 Enrollment ID: I20240917001498 |
| Provider Name | Nancy Lucas Castner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811728215 PECOS PAC ID: 4183155690 Enrollment ID: I20241008000753 |
| Provider Name | James William Lester |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952321309 PECOS PAC ID: 0446279566 Enrollment ID: I20250203002328 |
| Provider Name | Miguel Martin Palos |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790755460 PECOS PAC ID: 5193741254 Enrollment ID: I20250203002686 |
Telos, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 152 Grafton Road, Townshend, VT 05353 Phone: 802-365-4318 | |
Hearth Stone Internal Medicine, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 152 Grafton Rd, Townshend, VT 05353 Phone: 603-667-6272 |