Individual provider Active NPI

Emily Rose Burroughs, PA-C

  • Surgical Physician Assistant
  • Temple Terrace, FL
National Provider Identifier
1174819411
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9112018 Issued in FL
Practice address
13020 N Telecom Pkwy
Temple Terrace, FL 33637-0925
Phone
(813) 978-9700
Fax
(813) 558-6186
NPI assigned
Jun 24, 2011
Last updated
Nov 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 096002703 IL
Athletic Trainer 2255A2300X AL3190 FL
Athletic Trainer 2255A2300X 2010033069 MO
Surgical Physician Assistant 363AS0400X PA9112018 FL Primary

Addresses

Primary practice location

13020 N Telecom Pkwy
Temple Terrace, FL 33637-0925

Mailing address

13020 N Telecom Pkwy
Temple Terrace, FL 33637-0925
Phone (813) 978-9700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20190215000206 FL Practitioner - Physician Assistant 8921346016 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2600 Bruce B Downs Blvd
Wesley Chapel, FL 33544-9207
Phone (813) 929-5000

2653 Bruce B Downs Blvd
Suite 201
Wesley Chapel, FL 33544-9206
Phone (813) 978-9700

3334 Capital Medical Blvd
Suite 400
Tallahassee, FL 32308-4470
Phone (850) 877-8174

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AL3190FLMDAthletic Trainer
096002703ILMDAthletic Trainer
2010033069MOMDAthletic Trainer
PA9112018FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Musculoskeletal Institute Chartered CurrentSince Mar 9, 2021 Accepting new patients
Tallahassee Orthopedic Clinic III, P.L. CurrentSince Sep 17, 2024 Accepting new patients

Locations

13020 N Telecom Pkwy
Temple Terrace, FL 33637

13020 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

13060 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

5901 E Fowler Ave
Ste 100
Temple Terrace, FL 33617
Phone (813) 987-9700

2044 Trinity Oaks Blvd
Ste 110
Trinity, FL 34655
Phone (813) 978-7000

2653 Bruce B Downs Blvd
Ste 201
Wesley Chapel, FL 33544
Phone (813) 910-3368

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: emily.oakley.1@18802.direct.athenahealth.com
  • Direct secure messaging: emily.oakley.1@24583.direct.athenahealth.com

Organizations & group practices 4

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 3

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": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1174819411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13020 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370925",
            "telephone_number": "813-978-9700",
            "fax_number": "813-558-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13020 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370925",
            "telephone_number": "813-978-9700",
            "fax_number": "813-558-6186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURROUGHS",
        "first_name": "EMILY",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-24",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096002703",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL3190",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2010033069",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9112018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Terrace, FL

Sources for this page

Verify at the official NPI Registry.