Individual provider Active NPI

Daniel J Burst, PA

  • Medical Physician Assistant
  • Gretna, LA
National Provider Identifier
1063648525
Registry record updated Jun 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.200267 Issued in LA
Practice address
120 Meadowcrest St
Suite 300
Gretna, LA 70056-5255
Phone
(504) 392-7123
Fax
(504) 392-7823
NPI assigned
Jun 10, 2009
Last updated
Jun 10, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA.200267 LA Primary

Addresses

Primary practice location

120 Meadowcrest St
Suite 300
Gretna, LA 70056-5255

Mailing address

722 Central Ave
Reserve, LA 70084-5516
Phone (504) 392-7123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090721000127 LA Practitioner - Physician Assistant 5395897433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diagnostic and Interventional Spinal Care of LouisianaGroup PAC ID 0244460293, 10 clinicians

Practice addresses (Care Compare)

19184 Dr John Lambert Dr
Suite 103
Hammond, LA 70403-0936
Phone (985) 892-8934

76 Starbrush Cir
Covington, LA 70433-7208
Phone (985) 400-5778

76 Starbrush Circle
Covington, LA 70433-7208

Hospital & facility affiliations

  • Avala Hospital, Covington, LA, CCN 190267

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: dburst@disc-of-louisiana.direct.kno2fy.com

Organizations & group practices 1

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": "1244592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244592000000",
    "number": "1063648525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 CENTRAL AVE",
            "city": "RESERVE",
            "state": "LA",
            "postal_code": "700845516",
            "telephone_number": "504-392-7123",
            "fax_number": "504-392-7823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MEADOWCREST ST",
            "address_2": "SUITE 300",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700565255",
            "telephone_number": "504-392-7123",
            "fax_number": "504-392-7823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURST",
        "first_name": "DANIEL",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-10",
        "last_updated": "2009-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "LA",
            "license": "PA.200267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gretna, LA

Sources for this page

Verify at the official NPI Registry.