EDWIN GONCHARUK (D.O.) – Gastroenterology Physician, NPI 1255872453
Gastroenterology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
58 HOSPITALIST in VT
Provider Addresses for EDWIN GONCHARUK (D.O.)
130 Fisher Rd
Berlin, VT 056029516
Phone: (802) 225-1743
Type: Location
77 Plaza Blvd
Plattsburgh, NY 129016438
Phone: (518) 825-4437
Type: Location
University of Vermont Medical Center, 111, Colchester Avenue, Burlington, Chittenden County, Vermont, 05401, United States
UVMMC
BURLINGTON, VT 054011473
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: 2025-08-25
PECOS data refreshed: 2026-05-27
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 |
|---|---|---|---|---|
| I20200716000429 | I | Hospitalist | VT | TBD |
| I20250825003342 | I | Gastroenterology | NY | 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 05602)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | VT | |
| Nurse Practitioner | MA | |
| - | VT | |
| Certified Registered Nurse Anesthetist (Crna) | FL | |
| - | VT | |
| - | VT | |
| - | CT | |
| - | VT | |
| - | IN | |
| - | VT |
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