1. Home
  2. Directory
  3. Vermont
  4. South Burlington
  5. Family Medicine
  6. NPI Profile

DR. THEODORE R WISSINK MD
NPI 1124193503
Family Medicine in South Burlington, VT

Active since November 21, 2006PECOS EnrolledAccepts Medicare Assignment
118 TILLEY DR STE 201, SOUTH BURLINGTON, VT 05403(802) 847-5550(802) 847-3646 Get Directions Write a Review

NPPES record last updated: December 22, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Theodore R Wissink Md NPPES

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

DR. THEODORE R WISSINK MD (NPI 1124193503) is an individual family medicine provider in South Burlington, Vermont, licensed in Vermont (042.0019084) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS, is affiliated with Maine Medical Center, and maintains a secondary practice location in Portland.

NPPES Registry Identity

NPI1124193503
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. THEODORE R WISSINKCredential: MD
Location Address118 TILLEY DR STE 201South Burlington, VT 05403-4450
Mailing Address111 Colchester AveBurlington, VT 05401-1473 · (802) 847-0000
Phone(802) 847-5550
Fax(802) 847-3646
Sole ProprietorNo
Medical School CMSUniversity Of Minnesota Medical SchoolGraduated 2004
Enumeration DateNovember 21, 2006
Last NPPES UpdateDecember 22, 2025
NPPES CertifiedDecember 22, 2025
✔ NPI 1124193503 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in VT · 042.0019084✔ Licensed in ME · 017817
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
118 TILLEY DR STE 201, South Burlington, VT 05403
Open in Google Maps ↗

Secondary Practice Location 1

Location 1272 Congress StPortland, ME 04101 · Phone (207) 874-2466 · Fax (207) 774-4625

Other Identifiers 2

Medicaid432952299ME
Medicaid30207877NH

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Theodore R Wissink Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5890869770
PECOS Enrollment IDI20080812000033, I20251215003654
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
116 services77 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
100 services74 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
44 services26 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
32 services32 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
12 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Maine Medical Center

Acute Care Hospitals · Portland, ME
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number200009
Location22 Bramhall StPortland, ME 04102 · Cumberland County
Emergency services Birthing friendly

Univ. Of Vermont - Fletcher Allen Health Care

Acute Care Hospitals · Burlington, VT
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number470003
Location111 Colchester AveBurlington, VT 05401 · Chittenden County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 05403 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.89 typical visit price
range $55.80 – $168.48
Typical copayment $21.47 (range $13.95 – $42.12)
Most-billed visit code 99203
Established Patient
$98.40 typical visit price
range $18.08 – $137.84
Typical copayment $24.60 (range $4.52 – $34.46)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

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

MRS. KATHRYN RIDGELY APPLEGATE
Nurse Practitioner (Family)
118 TILLEY DR STE 201
SOUTH BURLINGTON, VT 05403
Chittenden County (802) 847-5550
MRS. EMILY B STONE MS, R.D.
Dietitian, Registered
118 TILLEY DR STE 201
S BURLINGTON, VT 05403
Chittenden County (802) 847-5833

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 Theodore Wissink's NPI number?

The NPI number for Theodore Wissink is 1124193503. It was assigned to this individual provider in the NPPES registry on November 21, 2006.

Where is Theodore Wissink located?

Theodore Wissink practices at 118 Tilley Dr Ste 201, South Burlington, VT 05403. The listed phone number is (802) 847-5550.

What is Theodore Wissink's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Theodore Wissink enrolled in Medicare?

Yes. Theodore Wissink is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Theodore Wissink accept?

Health plans from Anthem Blue Cross and Blue Shield and Harvard Pilgrim Health Care list Theodore Wissink 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.

Is Theodore Wissink affiliated with any hospitals?

According to CMS data, Theodore Wissink is affiliated with Maine Medical Center and Univ. Of Vermont - Fletcher Allen Health Care.

When was this NPI record last updated?

The NPPES record for Theodore Wissink was last updated on December 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.