STEPHEN J PHIPPS M.D.
NPI 1649265497
Ophthalmology in St Johnsbury, VT

Active since September 19, 2005PECOS EnrolledAccepts Medicare Assignment
1290 HOSPITAL DR, SUITE 5, ST JOHNSBURY, VT 05819(802) 748-8126 Get Directions Write a Review

NPPES record last updated: August 8, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Stephen J Phipps M.d. NPPES

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

STEPHEN J PHIPPS M.D. (NPI 1649265497) is an individual ophthalmology provider in St Johnsbury, Vermont, licensed in Vermont (042-0010054) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Littleton Regional Healthcare, and is a graduate of Creighton University School Of Medicine (1996).

NPPES Registry Identity

NPI1649265497
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameSTEPHEN J PHIPPSCredential: M.D.
Location Address1290 HOSPITAL DR, SUITE 5St Johnsbury, VT 05819-9239
Mailing Address1290 Hospital Dr, Suite 5Saint Johnsbury, VT 05819-9205 · (802) 748-8126 · Fax (802) 748-2208
Sole ProprietorYes
Medical School CMSCreighton University School Of MedicineGraduated 1996
Enumeration DateSeptember 19, 2005
Last NPPES UpdateAugust 8, 2016
NPI 1649265497 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Licenses Licensed in VT · 042-0010054 Licensed in NH · 10966
Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

1290 HOSPITAL DR, St Johnsbury, VT 05819

Other Identifiers 5

Medicare ID-Type UnspecifiedRE5905NH
Medicaid0VN2361VT
Medicare ID-Type UnspecifiedVN2361VT
Medicaid30201296NH
Medicare UPINH22707VT

Accepted 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

Stephen J Phipps 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 ID7315938164
PECOS Enrollment IDI20040520000451, I20040609000118
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 19

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.

Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
548 services327 patients
Measurement of corneal curvature and depth of eye 92136
This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.
392 services391 patients
Release of arm or leg nerve 64708
A release of an arm or leg nerve is a surgical procedure aimed at relieving pressure on the nerve. This pressure can cause pain, numbness, or weakness. During the procedure, the surgeon makes a small incision and gently moves tissues away from the nerve. This can help restore normal function and alleviate discomfort.
308 services182 patients
Release of nerve using operating microscope 64727
This procedure, called a microsurgical nerve release, involves using a special microscope to enhance precision while freeing a trapped nerve. It can help alleviate pain and improve nerve function. It's a safe and effective method often used for conditions like carpal tunnel syndrome.
306 services181 patients
Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes 99152
This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.
302 services181 patients
Measurement of corneal curvature and depth of eye 92136
This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.
262 services262 patients

Hospital Affiliations CMS Care Compare 2

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

Littleton Regional Healthcare

Critical Access Hospitals · Littleton, NH
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number301302
Location600 St Johnsbury RoadLittleton, NH 03561 · Grafton County
Emergency services

Northeastern Vermont Regional Hospital

Critical Access Hospitals · Saint Johnsbury, VT
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number471303
Location1315 Hospital DriveSaint Johnsbury, VT 05819 · Caledonia County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 05819 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
$69.56 typical visit price
range $18.08 – $137.84
Typical copayment $17.39 (range $4.52 – $34.46)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
100%77 patients5/55-star benchmark: 100%
Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus…
24%25 patients1/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%2,683 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Frames, purchases V2020
Other-Vision, Hearing, and Speech Services · category OC000N
4 suppliers40 claims40 services$52.09 avg. paid by Medicare
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens V2103
Other-Vision, Hearing, and Speech Services · category OC000N
3 suppliers11 claims17 services$21.86 avg. paid by Medicare
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens V2203
Other-Vision, Hearing, and Speech Services · category OC000N
4 suppliers20 claims33 services$42.12 avg. paid by Medicare
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens V2303
Other-Vision, Hearing, and Speech Services · category OC000N
4 suppliers30 claims49 services$53.53 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 10

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

Durable Medical Equipment & Medical Supplies
1290 HOSPITAL DR, SUITE 5
ST JOHNSBURY, VT 05819
Internal Medicine
1290 HOSPITAL DR, STE 2
ST JOHNSBURY, VT 05819
Optometrist
1290 HOSPITAL DR, SUITE 5
ST JOHNSBURY, VT 05819
Optometrist
1290 HOSPITAL DR, SUITE 5
ST JOHNSBURY, VT 05819
Ophthalmology
1290 HOSPITAL DR, SUITE 5
ST JOHNSBURY, VT 05819
Surgery
1290 HOSPITAL DR
ST JOHNSBURY, VT 05819
Clinic/Center (Ambulatory Surgical)
1290 HOSPITAL DR
ST JOHNSBURY, VT 05819
Ophthalmology
1290 HOSPITAL DR, SUITE 5
ST JOHNSBURY, VT 05819

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 Stephen Phipps's NPI number?

The NPI number for Stephen Phipps is 1649265497. It was assigned to this individual provider in the NPPES registry on September 19, 2005.

Where is Stephen Phipps located?

Stephen Phipps practices at 1290 Hospital Dr Suite 5, St Johnsbury, VT 05819. The listed phone number is (802) 748-8126.

What is Stephen Phipps's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Stephen Phipps enrolled in Medicare?

Yes. Stephen Phipps 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 Stephen Phipps accept?

Health plans from Ambetter from NH Healthy Families, Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care and WellSense Health Plan list Stephen Phipps 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 Stephen Phipps affiliated with any hospitals?

According to CMS data, Stephen Phipps is affiliated with Littleton Regional Healthcare and Northeastern Vermont Regional Hospital.

When was this NPI record last updated?

The NPPES record for Stephen Phipps was last updated on August 8, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.