Individual provider Active NPI

Michael Burry, M.D.

  • General Practice Physician
  • Cupertino, CA
National Provider Identifier
1205286564
Registry record updated Jun 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A68709 Issued in CA
Practice address
20400 Stevens Creek Blvd
Ste 840
Cupertino, CA 95014-2217
Phone
(408) 441-8400
NPI assigned
Jun 17, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A68709 CA Primary

Addresses

Primary practice location

20400 Stevens Creek Blvd
Ste 840
Cupertino, CA 95014-2217

Mailing address

20400 Stevens Creek Blvd
Ste 840
Cupertino, CA 95014-2217
Phone (408) 441-8400

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A68709CAMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1466121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1205286564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20400 STEVENS CREEK BLVD",
            "address_2": "STE 840",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950142217",
            "telephone_number": "408-441-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20400 STEVENS CREEK BLVD",
            "address_2": "STE 840",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950142217",
            "telephone_number": "408-441-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRY",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-17",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A68709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cupertino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.