DR. MICHAEL A NISSENBAUM (MD) – Diagnostic Radiology Physician, NPI 1356328975
Diagnostic Radiology Physician
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NPPES metrics only — not quality of care.
106 DIAGNOSTIC RADIOLOGY in VT
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Provider Addresses for DR. MICHAEL A NISSENBAUM (MD)
333, Wade Pasture Road, Stowe, Lamoille County, Vermont, 05672, United States
STOWE, VT 056725384
Phone: (952) 595-1100
Fax: (612) 294-4903
Type: Location
11995, Singletree Lane, Eden Prairie, Hennepin County, Minnesota, 55344, United States
STE 500
EDEN PRAIRIE, MN 553445347
Phone: (952) 595-1301
Fax: (612) 294-4903
Type: Mailing
3841 GREEN HILLS VILLAGE DR STE 200
NASHVILLE, TN 372152691
Phone:
Type: Mailing
11995 SINGLETREE LN STE 500
EDEN PRAIRIE, MN 553445349
Phone: (952) 595-1301
Fax: (612) 294-4903
Type: Mailing
700 NE 13th St
Oklahoma City, OK 731045004
Phone: (405) 271-3741
Type: Location
1 Medical Center Dr
Lebanon, NH 037560001
Phone: (603) 650-5000
Type: Location
1001 Sam Perry Blvd
Fredericksburg, VA 224014453
Phone: (540) 741-5610
Type: Location
3600 Minnesota Dr Ste 800
Edina, MN 554357915
Phone: (952) 595-1100
Fax: (612) 294-4903
Type: Location
101 Hospital Center Blvd
Stafford, VA 225546200
Phone: (540) 741-5610
Type: Location
3601 THE VANDERBILT CLINIC
NASHVILLE, TN 372325349
Phone: (615) 322-3000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $23.
Total Amount is formed as General ($23) + Research ($0) + Ownership ($0) = $23.
Last reported payment date: 2023-02-11 • Largest payer in this snapshot: Abbott Laboratories ($23).
Total Amount
$23
General + Research + Ownership
Payments
1
Total payment records
General Amount
$23
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-02-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $23 |
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: 2025-02-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 5 Medicare enrollment records; no due dates published yet.
Enrollment records
5
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 |
|---|---|---|---|---|
| I20170324001035 | I | Diagnostic Radiology | VT | TBD |
| I20240718000564 | I | Diagnostic Radiology | NH | TBD |
| I20240723004700 | I | Diagnostic Radiology | PA | TBD |
| I20241127002538 | I | Diagnostic Radiology | TN | TBD |
| I20250219000247 | I | Diagnostic Radiology | NJ | 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 |
|---|---|---|---|---|
| 70450 | Ct scan head or brain without contrast | 283 | 281 | $0 |
| 74176 | Ct scan of abdomen and pelvis without contrast | 109 | 109 | $0 |
| 74177 | Ct scan of abdomen and pelvis with contrast | 104 | 104 | $0 |
| 72125 | Ct scan of upper spine without contrast | 92 | 92 | $0 |
| 71045 | X-ray of chest, 1 view | 91 | 88 | $0 |
Insurance plans in this area (ZIP 05672)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | NH | |
| Cardiovascular Disease (Cardiology) | AZ | |
| - | NH | |
| P S Y C H I A T R Y | NH | |
| - | NH | |
| - | VT | |
| - | CA | |
| - | NH | |
| - | NH | |
| Physician Assistant | NH |
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