DR. GLENN DAVID GOLDMAN (MD) – MOHS-Micrographic Surgery Physician, NPI 1992717458
MOHS-Micrographic Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
39 DERMATOLOGY in VT
Provider Addresses for DR. GLENN DAVID GOLDMAN (MD)
111 Colchester Ave
WP - 5
Burlington, VT 054011473
Phone: (802) 847-4570
Type: Location
University of Vermont Medical Center, 111, Colchester Avenue, Burlington, Chittenden County, Vermont, 05401, United States
WP - 5
BURLINGTON, VT 054011473
Phone: (802) 847-4570
Type: Location
354 MOUNTAIN VIEW DR STE 300
COLCHESTER, VT 054465988
Phone: (802) 864-0192
Fax: (802) 860-4919
Type: Location
358, Chamberlin Lane, Taft Corners, Williston, Chittenden County, Vermont, 15495, United States
WILLISTON, VT 054954406
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: 2005-02-28
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 |
|---|---|---|---|---|
| I20050228000885 | I | Dermatology | 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 |
|---|---|---|---|---|
| 17311 | Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks | 593 | 481 | $0 |
| 17003 | Destruction of precancer skin growth, 2-14 growths | 396 | 93 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 233 | 190 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 194 | 145 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 170 | 135 | $0 |
Insurance plans in this area (ZIP 05401)
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Provider's Procedures
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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