Individual provider Active NPI

John Robert Burroughs, MD

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Colorado Springs, CO
National Provider Identifier
1003866484
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X
License
44251 Issued in CO
Practice address
300 Garden of the Gods Rd
Ste 100
Colorado Springs, CO 80907
Phone
(719) 473-8801
Fax
(719) 473-8581
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 44251 CO
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X 44251 CO Primary

Addresses

Primary practice location

300 Garden of the Gods Rd
Ste 100
Colorado Springs, CO 80907

Mailing address

300 Garden of the Gods Rd
Ste 100
Colorado Springs, CO 80907
Phone (719) 749-3606

Other identifiers 3

IdentifierTypeStateIssuer
DF0561OtherRR MEDICARE
1003866484OtherNPI
21637229MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060328000097 CO Practitioner - Maxillofacial SurgeryPractitioner - OphthalmologyPractitioner - Plastic and Reconstructive Surgery 6608857594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Ophthalmology, Plastic and Reconstructive Surgery
Education
Uniformed Services Uhs Fe Hebert School of Med, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

300 Garden of the Gods Rd
Suite 100
Colorado Springs, CO 80907-4246
Phone (719) 473-8801

Merit-based Incentive Payment System (MIPS)

Final score
75.69 of 100Reported as group
Quality
71.4
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
44251COMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John R. Burroughs MD PC Ophthalmology CurrentSince Jan 1, 2008 Accepting new patients
Oculoplastic Surgery, Inc. Ophthalmology PastSince Oct 1, 2023 Accepting new patients

Locations

300 Garden of the Gods Rd
Ste 100
Colorado Springs, CO 80907
Phone (719) 473-8801

111 E Polk St
Colorado Springs, CO 80907
Phone (719) 473-8801

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1003866484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 GARDEN OF THE GODS RD",
            "address_2": "STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80907",
            "telephone_number": "719-749-3606",
            "fax_number": "719-473-8581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 GARDEN OF THE GODS RD",
            "address_2": "STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80907",
            "telephone_number": "719-473-8801",
            "fax_number": "719-473-8581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURROUGHS",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CO",
            "license": "44251",
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "CO",
            "license": "44251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DF0561",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1003866484",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21637229",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.