Individual provider Active NPI

Patricia R. Burris-Warmoth, M.D.

  • Adolescent Medicine (Internal Medicine) Physician
  • Melville, NY
National Provider Identifier
1194898676
Registry record updated Feb 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X
License
198810 Issued in NY
Practice address
80 Marcus Dr
Provider Enrollment
Melville, NY 11747-4230
Phone
(631) 391-7889
Fax
(631) 454-4163
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Internal Medicine) Physician 207RA0000X 198810 NY Primary

Addresses

Primary practice location

80 Marcus Dr
Provider Enrollment
Melville, NY 11747-4230

Mailing address

14601 45TH Ave Ste 140
Flushing, NY 11355-2200
Phone (718) 670-5534

Other identifiers 2

IdentifierTypeStateIssuer
01777462MedicaidNY
NYS LICENSEOtherNY198810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20050128000483 NY Practitioner - Pediatric Medicine 2365492105 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Flushing Hospital Medical Center CurrentSince Feb 1, 2012 Accepting new patients
TJH Medical Services, P.C. CurrentSince Jul 14, 2018 Accepting new patients
Flushing Hospital & Medical Center CurrentSince Feb 1, 2012 Accepting new patients
TJH Medical Services, PC Past Accepting new patients

Locations

4500 Parsons Blvd
Flushing, NY 11355
Phone (718) 670-5631

4500 Parsons Blvd
Fl 5
Flushing, NY 11355

14601 45th Ave
Ste 140
Flushing, NY 11355

14601 45th Ave
Flushing, NY 11355
Phone (718) 670-5562

11940 Metropolitan Ave
Kew Gardens, NY 11415
Phone (718) 849-0839

80 Marcus Dr
Melville, NY 11747
Phone (631) 391-7889

Interoperability endpoints

  • Direct secure messaging: pburriswarmoth6783@direct.medisys.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392940800000",
    "number": "1194898676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14601 45TH AVE STE 140",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113552200",
            "telephone_number": "718-670-5534",
            "fax_number": "718-670-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 MARCUS DR",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474230",
            "telephone_number": "631-391-7889",
            "fax_number": "631-454-4163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRIS-WARMOTH",
        "first_name": "PATRICIA",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2014-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "NY",
            "license": "198810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01777462",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "198810",
            "identifier": "NYS LICENSE",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

Verify at the official NPI Registry.