AUTUMN SACKLOW (MD) – Surgery Physician, NPI 1427552678
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
84 GENERAL SURGERY in VT
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Provider Addresses for AUTUMN SACKLOW (MD)
129 WILLIAMS RD
PRESQUE ISLE, ME 047695266
Phone:
Type: Mailing
University of Vermont Medical Center, 111, Colchester Avenue, Burlington, Chittenden County, Vermont, 05401, United States
BURLINGTON, VT 054011473
Phone: (802) 847-2345
Type: Location
140 ACADEMY ST # 10
PRESQUE ISLE, ME 047693102
Phone: (207) 764-6310
Fax: (207) 764-6993
Type: Location
3162, Greenbush Road, Charlotte, Chittenden County, Vermont, 05445, United States
CHARLOTTE, VT 054459312
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-08-11
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240717000868 | I | General Surgery | ME | TBD |
| I20250811001678 | I | General Surgery | VT | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 04769)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | VT | |
| Emergency Medicine, Family Practice, Emergency Medicine | VT | |
| Nurse Practitioner | VT | |
| Physical Therapist In Private Practice | VT | |
| - | VT | |
| O B S T E T R I C S/ G Y N E C O L O G Y | NY | |
| Cardiovascular Disease (Cardiology) | NJ | |
| Certified Registered Nurse Anesthetist (Crna) | VT | |
| - | VT | |
| Certified Registered Nurse Anesthetist (Crna) | NH |
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