Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Theodore R Wissink, MD

Individual provider Family Medicine Physician · NPI 1124193503

Dr. Theodore R Wissink, MD is a Family Practice in South Burlington, Vermont. Graduated from University of Minnesota Medical School in 2004, 22 years ago. Practices with University of Vermont Medical Center Inc, a 1,202-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Maine and Vermont.

Years since qualifying
22
Trained at
University of Minnesota Medical School
Licensed in
ME, VT
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

118 Tilley Dr Ste 201
South Burlington, VT 05403-4450
Phone: (802) 847-5550
Fax: (802) 847-3646
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 272 Congress St, Portland, ME 04101 — (207) 874-2466

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 042.0019084 (VT)
Family Medicine Physician Taxonomy 207Q00000X · Licence 017817 (ME)

Record details

NPI number1124193503
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedNovember 21, 2006
Last updated in NPPESDecember 22, 2025
Certification dateDecember 22, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated 2004 (22 years in practice)
Group practice University Of Vermont Medical Center Inc — 1202 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations6 on file with Medicare

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