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FOUR SEASONS DERMATOLOGY
NPI 1093577827
Dermatology in Colchester, VT

Active since January 26, 2024CLIA Certified · 4 labs
354 MOUNTAIN VIEW DR, COLCHESTER, VT 05446(802) 864-0192 Get Directions Write a Review

NPPES record last updated: October 11, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 11, 2024, Sep 13, 2024 (2 updates tracked since 2024).

About Four Seasons Dermatology NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FOUR SEASONS DERMATOLOGY (NPI 1093577827) is a healthcare organization registered as a dermatology in Colchester, Vermont and active in the NPI registry since January 2024. The organization holds 4 active CLIA laboratory certificates, maintains a secondary practice location in Plattsburgh, and lists Jennifer Haley, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1093577827
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameGREEN MOUNTAIN DERMATOLOGY PLLC
Location Address354 MOUNTAIN VIEW DRColchester, VT 05446-5968
Mailing Address4700 Exchange Ct Ste 100Boca Raton, FL 33431-4450 · (561) 314-2000
Phone(802) 864-0192
Organization SubpartNo
Authorized OfficialJennifer HaleyAuthorized Official · (561) 314-2000
Enumeration DateJanuary 26, 2024
Last NPPES UpdateOctober 11, 20242 updates tracked since enumeration
NPPES CertifiedOctober 11, 2024
✔ NPI 1093577827 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
354 MOUNTAIN VIEW DR, Colchester, VT 05446
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Other Names 1

Doing Business AsFour Seasons Dermatology

Secondary Practice Location 1

Location 12 Healey AvePlattsburgh, NY 12901-2413 · Phone (802) 864-0192

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

CLIA Laboratory Certificates CMS CLIA 5

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 47D0091021

Four Seasons Dermatology LLC · Colchester, VT
Active · expires Aug 31, 2026
CLIA Number47D0091021
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorSteven Partilo MD
Laboratory Phone(802) 864-0192
Laboratory LocationFour Seasons Dermatology LLC354 Mountain View Dr -- Suite 300, Colchester, VT 05446
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 33D2170852

Four Seasons Dermatology LLC · Plattsburgh, NY
Active · expires Aug 20, 2027
CLIA Number33D2170852
Laboratory TypePhysician Office
Certificate Effective DateAugust 21, 2025
Certificate Expiration DateAugust 20, 2027
Laboratory DirectorSteven R. Partilo
Laboratory Phone(518) 310-3161
Laboratory LocationFour Seasons Dermatology LLC2 Healey Avenue, Plattsburgh, NY 12901
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Compliance 47D2199404

Four Season Dermatology · Colchester, VT
Active · expires Jun 1, 2027
CLIA Number47D2199404
Laboratory TypePhysician Office
Certificate Effective DateJune 2, 2025
Certificate Expiration DateJune 1, 2027
Laboratory DirectorGlenn D. Goldman
Laboratory Phone(802) 864-0192
Laboratory LocationFour Season Dermatology354 Mountain View Dr, Ste 300, Colchester, VT 05446
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 47D2218980

Four Seasons Dermatology · Waterbury, VT
Active · expires Mar 31, 2027
CLIA Number47D2218980
Laboratory TypePhysician Office
Certificate Effective DateApril 1, 2025
Certificate Expiration DateMarch 31, 2027
Laboratory DirectorSteven Partilo
Laboratory Phone(802) 864-0192
Laboratory LocationFour Seasons Dermatology28 Stowe St, Ste 3, Waterbury, VT 05676
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 47D1057491

Four Seasons Dermatology LLC · Rutland, VT
Expired · Aug 13, 2026
CLIA Number47D1057491
Laboratory TypePhysician Office
Certificate Effective DateAugust 14, 2024
Certificate Expiration DateAugust 13, 2026
Laboratory DirectorSteven R. Partillo
Laboratory Phone(802) 864-0192
Laboratory LocationFour Seasons Dermatology LLC253 Stratton Rd, Rutland, VT 05701
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LEAH TERESA VILLEMAIRE P.A.-C
Physician Assistant
354 MOUNTAIN VIEW DR, SUITE 300
COLCHESTER, VT 05446
Chittenden County (802) 864-0192
MR. DAVID STEPHEN GAWLIK PA-C, MS
Physician Assistant (Surgical)
354 MOUNTAIN VIEW DR, SUITE 300
COLCHESTER, VT 05446
Chittenden County (802) 864-0192
MS. EMILY ROSE KAVOUKSORIAN P.A. - C
Physician Assistant (Surgical)
354 MOUNTAIN VIEW DR, SUITE 103
COLCHESTER, VT 05446
Chittenden County (802) 847-3340
MH HEALTH CARE SERVICES, PC
Non-Pharmacy Dispensing Site
354 MOUNTAIN VIEW DR, SUITE 300
COLCHESTER, VT 05446
Chittenden County (802) 857-0400
ANITA LOUISE GOODRICH MD
Dermatology
354 MOUNTAIN VIEW DR, SUITE 300
COLCHESTER, VT 05446
Chittenden County (802) 864-0192
MS. MARY B HARKIN N.P.
Nurse Practitioner
354 MOUNTAIN VIEW DR, SUITE 300
COLCHESTER, VT 05446
Chittenden County (802) 864-0192
MRS. BEVERLEY FLANAGAN RAYMOND NP-C
Nurse Practitioner (Adult Health)
354 MOUNTAIN VIEW DR, SUITE 300
COLCHESTER, VT 05446
Chittenden County (802) 857-0400
ROBERT DAVID NESBIT MD
Surgery (Plastic and Reconstructive Surgery)
354 MOUNTAIN VIEW DR, FAHC PLASTIC SURGERY
COLCHESTER, VT 05446
Chittenden County (802) 847-3340

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Green Mountain Dermatology PLLC's NPI number?

The NPI number for Green Mountain Dermatology PLLC is 1093577827. It was assigned to this organization in the NPPES registry on January 26, 2024. The provider is doing business as Four Seasons Dermatology.

Where is Green Mountain Dermatology PLLC located?

Green Mountain Dermatology PLLC is located at 354 Mountain View Dr, Colchester, VT 05446. The listed phone number is (802) 864-0192.

What is Green Mountain Dermatology PLLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Green Mountain Dermatology PLLC hold CLIA laboratory certificates?

Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Green Mountain Dermatology PLLC accept?

Health plans from Anthem Blue Cross and Blue Shield list Green Mountain Dermatology PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Green Mountain Dermatology PLLC was last updated on October 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.