Individual provider Active NPI

Leonid Igorevich Burunchenko, MD

  • Emergency Medicine Physician
  • Manahawkin, NJ
National Provider Identifier
1033608583
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MA11043200 Issued in NJ
Practice address
1140 Route 72 W
Manahawkin, NJ 08050-2412
Phone
(609) 597-6011
NPI assigned
May 9, 2018
Last updated
Nov 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 309491 NY
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 25MA11043200 NJ Primary

Addresses

Primary practice location

1140 Route 72 W
Manahawkin, NJ 08050-2412

Mailing address

15 Abingdon Ave
Medford, NJ 08055-3361
Phone (267) 970-7209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20220420000356 NJ Practitioner - Emergency Medicine 5395146377 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Drexel University College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barron Emergency Physicians LLCGroup PAC ID 8820083785, 99 clinicians

Practice addresses (Care Compare)

1140 Route 72 W
Manahawkin, NJ 08050-2412
Phone (954) 939-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
39.04 of 100Reported as individual
Quality
30
Improvement activities
0
Cost
58.78

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ihpnj ER LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Barron Emergency Physicians LLC Emergency Medicine CurrentSince Mar 1, 2022 Accepting new patients

Locations

29 E 29th St
Bayonne, NJ 07002
Phone (201) 585-5000

176 Palisade Ave
Jersey City, NJ 07306
Phone (201) 795-8200

1140 Route 72 W
Stafford Township, NJ 08050
Phone (609) 978-2194

425 Jack Martin Blvd
Wall Township, NJ 08724
Phone (732) 840-2200

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1033608583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 ABINGDON AVE",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080553361",
            "telephone_number": "267-970-7209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 ROUTE 72 W",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080502412",
            "telephone_number": "609-597-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURUNCHENKO",
        "first_name": "LEONID",
        "middle_name": "IGOREVICH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-09",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "309491",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA11043200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manahawkin, NJ

Sources for this page

Verify at the official NPI Registry.