DR. SAMUEL EVENSON (M.D.) – Psychiatry Physician, NPI 1124559075
Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
155 PSYCHIATRY in VT
Provider Addresses for DR. SAMUEL EVENSON (M.D.)
130 Fisher Rd Unit 1
Berlin, VT 056028132
Phone: (802) 371-4316
Type: Location
115 Porter Dr
Middlebury, VT 057538629
Phone: (802) 338-4430
Type: Location
350 FISHER RD
MONTPELIER, VT 056337901
Phone: (802) 828-3300
Fax: (802) 828-2749
Type: Mailing
111 Colchester Ave
Burlington, VT 054011473
Phone: (802) 847-2345
Type: Location
7309, West Chesapeake Lane, Sioux Falls, Minnehaha County, South Dakota, 57106, United States
SIOUX FALLS, SD 571064504
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
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: 2021-06-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20210617001257 | I | Psychiatry | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99231 | Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 105 | 19 | $0 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 61 | 13 | $0 |
| 99239 | Hospital discharge day management, more than 30 minutes | 13 | 13 | $0 |
Insurance plans in this area (ZIP 05602)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | VT | |
| - | VT | |
| P S Y C H I A T R Y | VT | |
| P S Y C H I A T R Y | NJ | |
| P S Y C H I A T R Y | NY | |
| P S Y C H I A T R Y | VT |
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