DR. JEREMIAH E DICKERSON (MD) – Psychiatry Physician, NPI 1669511341

DR. JEREMIAH E DICKERSON (MD) is a healthcare provider. based in Burlington, Vermont. specializing in PSYCHIATRY. They hold the professional credentials MD. They hold a License No. 042-0011801 (VT). The NPI Number for DR. JEREMIAH E DICKERSON (MD) is 1669511341

Main info

Male
Sole Proprietor
21 Years Of Experience
Accepts Medicare Assignment
Name
DR. JEREMIAH E DICKERSON (MD)
NPI
1669511341
Phone
(802) 847-0000
Address
111 COLCHESTER AVE
Enumeration Date
6 February 2007
Last Update Date
25 March 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8028470000
Graduation Year
2005 (21 years ago)
PAC ID
0840468526
Group Practice PAC ID
3779491071
Professional Enrollment ID
I20110725000173
Address ID
VT054011473BU111XXAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:19State licenses:1Digital endpointsOther names

156 PSYCHIATRY in VT

Provider Addresses for DR. JEREMIAH E DICKERSON (MD)

  • 111 COLCHESTER AVE

    BURLINGTON, VT 054011473

    Phone: (802) 847-0000

    Type: Mailing

  • 1 S PROSPECT ST

    3RD FLOOR

    BURLINGTON, VT 054013456

    Phone: (802) 847-0000

    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: 2011-07-25

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110725000173IPsychiatryVTTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes4318$0
View full utilization report →

Insurance plans in this area (ZIP 05401)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3779491071View full group profile

Reviews

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Frequently asked questions

Can I cross-check DR. JEREMIAH E DICKERSON (MD) using NPI 1669511341?
NPI 1669511341 belongs to DR. JEREMIAH E DICKERSON (MD); compare other details if you need extra assurance.
Would DR. JEREMIAH E DICKERSON (MD) appear as active to a payer?
You can treat DR. JEREMIAH E DICKERSON (MD) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to DR. JEREMIAH E DICKERSON (MD)?
DR. JEREMIAH E DICKERSON (MD)'s specialty line reads Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Is DR. JEREMIAH E DICKERSON (MD) located near Burlington?
DR. JEREMIAH E DICKERSON (MD) currently maps to Burlington, Vermont in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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