Active NPI
Patrick Landon Burrup, PA-C
- Physician Assistant
- Sun City West, AZ
National Provider Identifier
1033429600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 4698
- Practice address
- 14502 Meeker Blvd
Sun City West, AZ 85375 - Phone
- (623) 214-4000
- Fax
- (623) 975-8752
- NPI assigned
- Oct 18, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 4698 | AZ | Primary |
Addresses
Primary practice location
14502 Meeker Blvd
Sun City West, AZ 85375
Mailing address
2100 Powell Street Suite 900
Emeryville, CA 94608-1803
Phone (510) 350-2600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4698 | AZ | MD | Child Mental Illness Respite Care |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287360000000",
"number": "1033429600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 POWELL STREET SUITE 900",
"city": "EMERYVILLE",
"state": "CA",
"postal_code": "946081803",
"telephone_number": "510-350-2600",
"fax_number": "510-879-9100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14502 MEEKER BLVD",
"city": "SUN CITY WEST",
"state": "AZ",
"postal_code": "85375",
"telephone_number": "623-214-4000",
"fax_number": "623-975-8752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURRUP",
"first_name": "PATRICK",
"middle_name": "LANDON",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-18",
"last_updated": "2010-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "4698",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sun City West, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.