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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. CLAYTON ROSS WILBURN M.D.
NPI 1609130681
Pathology - Clinical Pathology in Burlington, VT

Active since June 25, 2012PECOS EnrolledAccepts Medicare Assignment
111 COLCHESTER AVE, BURLINGTON, VT 05401(802) 847-9657(802) 847-3509 Get Directions Write a Review

NPPES record last updated: September 29, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 29, 2026, Jan 28, 2019 (2 updates tracked since 2019).

About Dr. Clayton Ross Wilburn M.d. NPPES

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

DR. CLAYTON ROSS WILBURN M.D. (NPI 1609130681) is an individual clinical pathology provider in Burlington, Vermont, licensed in Vermont (042.0013716) and active in the NPI registry since June 2012. He is enrolled in Medicare PECOS, is affiliated with Champlain Valley Physicians Hospital Medical Ctr, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1609130681
Entity TypeIndividualMale
Primary Taxonomy207ZC0006X
Provider Legal NameDR. CLAYTON ROSS WILBURNCredential: M.D.
Location Address111 COLCHESTER AVEBurlington, VT 05401-1473
Mailing Address111 Colchester AveBurlington, VT 05401-1473
Phone(802) 847-9657
Fax(802) 847-3509
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateJune 25, 2012
Last NPPES UpdateSeptember 29, 20262 updates tracked since enumeration
NPPES CertifiedSeptember 29, 2026
✔ NPI 1609130681 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPathology · Clinical PathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ZC0006X
Licenses✔ Licensed in VT · 042.0013716✔ Licensed in TX · 15-541
Definition
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
111 COLCHESTER AVE, Burlington, VT 05401
Open in Google Maps ↗

Other Identifiers 1

Other567339TX · Texas Medical Board

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Clayton Ross Wilburn M.d. 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 ID4688942147
PECOS Enrollment IDI20170626000571
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Clayton Wilburn reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Of Vermont Medical Center Inc
0.1 mi
Internal Medicine
111 COLCHESTER AVE
Burlington, VT 05401
  • Reassigned Medicare billing, Vermont enrollment
  • 1,643 clinicians in this Medicare group
NPI 1659309615 (802) 847-0000
Central Vermont Medical Center Inc
36 mi
Internal Medicine
130 FISHER RD
Berlin, VT 05602
  • Reassigned Medicare billing, Vermont enrollment
  • Also billed through NPI 1023028784 (Vermont)
  • 183 clinicians in this Medicare group
NPI 1831374362 (802) 371-4392

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

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.

Immunologic analysis technique on serum (immunofixation) 86334
Immunofixation is a lab test that helps identify proteins called immunoglobulins in your blood serum. These proteins are part of your immune system. Changes in their levels can indicate certain diseases. The test is simple and only requires a blood sample.
1,638 services1,182 patients
Immunologic analysis technique on body fluid, other fluids with concentration 86335
Immunologic analysis is a diagnostic method that assesses your body fluids to detect health issues. It involves concentrating these fluids to enhance detection of specific proteins or cells. It helps identify immune system responses, aiding in accurate diagnosis and treatment.
392 services358 patients
Hemoglobin analysis and measurement, electrophoresis 83020
Hemoglobin analysis and measurement, electrophoresis, is a lab test that separates and identifies proteins in your blood. It's used to diagnose conditions affecting red blood cells. It's a simple, painless procedure where a small blood sample is taken and analyzed.
35 services35 patients

Hospital Affiliations CMS Care Compare 5

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

Champlain Valley Physicians Hospital Medical Ctr

Acute Care Hospitals · Plattsburgh, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330250
Location75 Beekman StreetPlattsburgh, NY 12901 · Clinton County
Emergency services Birthing friendly

The University Of Vermont Health Network-Alice Hy

Critical Access Hospitals · Malone, NY
OwnershipVoluntary non-profit - Private
CMS Certification Number331321
Location133 Park Street, PO Box 729Malone, NY 12953 · Franklin County
Emergency services

Central Vermont Medical Center

Acute Care Hospitals · Barre, VT
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number470001
LocationBox 547Barre, VT 05641 · Washington 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

Porter Hospital, Inc

Critical Access Hospitals · Middlebury, VT
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number471307
Location115 Porter DriveMiddlebury, VT 05753 · Addison County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 05401 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
$127.71 typical visit price
range $55.80 – $168.48
Typical copayment $31.92 (range $13.95 – $42.12)
Most-billed visit code 99204
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 20

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

ELENA KOZAKEWICH
Internal Medicine (Pulmonary Disease)
111 COLCHESTER AVE, UVM MEDICAL CENTER, DEPT OF INTERNAL MEDICINE, 222WP2
BURLINGTON, VT 05401
Chittenden County (802) 847-2700
RICHARD BOHLING CAROZZA MD
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
111 COLCHESTER AVE
BURLINGTON, VT 05401
Chittenden County (802) 847-4589
ANDREW HUY NGUYEN MD
Radiology (Diagnostic Radiology)
111 COLCHESTER AVE
BURLINGTON, VT 05401
Chittenden County (802) 847-0000
DR. KELLY CURTIS BLANCHET MD
Pediatrics
111 COLCHESTER AVE
BURLINGTON, VT 05401
Chittenden County (802) 847-2345
LINDSAY ANNE CALDARONE MD
Student in an Organized Health Care Education/Training Program
111 COLCHESTER AVE
BURLINGTON, VT 05401
Chittenden County (802) 847-2345
SHAWN LANSING
Student in an Organized Health Care Education/Training Program
111 COLCHESTER AVE
BURLINGTON, VT 05401
Chittenden County (802) 847-2345
HANNA S LOVING PHD
Pathology (Clinical Laboratory Director, Non-physician)
111 COLCHESTER AVE
BURLINGTON, VT 05401
Chittenden County (802) 847-5121
KAITLYN MARIE DILLON DNP, APRN, FNP-C
Nurse Practitioner
111 COLCHESTER AVE
BURLINGTON, VT 05401
Chittenden County (802) 847-0000

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 Clayton Wilburn's NPI number?

The NPI number for Clayton Wilburn is 1609130681. It was assigned to this individual provider in the NPPES registry on June 25, 2012.

Where is Clayton Wilburn located?

Clayton Wilburn practices at 111 Colchester Ave, Burlington, VT 05401. The listed phone number is (802) 847-9657.

What is Clayton Wilburn's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Clinical Pathology, with taxonomy code 207ZC0006X.

Is Clayton Wilburn enrolled in Medicare?

Yes. Clayton Wilburn 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.

Which organizations bill Medicare for Clayton Wilburn's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Clayton Wilburn reassigns Medicare benefits to 2 organizations: University Of Vermont Medical Center Inc (Burlington, VT) and Central Vermont Medical Center Inc (Berlin, VT). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Clayton Wilburn's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Clayton Wilburn accept?

Health plans from Anthem Blue Cross and Blue Shield list Clayton Wilburn 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 Clayton Wilburn affiliated with any hospitals?

According to CMS data, Clayton Wilburn is affiliated with Champlain Valley Physicians Hospital Medical Ctr, The University Of Vermont Health Network-Alice Hy, Central Vermont Medical Center, Univ. Of Vermont - Fletcher Allen Health Care and Porter Hospital, Inc.

When was this NPI record last updated?

The NPPES record for Clayton Wilburn was last updated on September 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 25 days 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.