NPIMap

Individual provider Active NPI

Eric Jason Burks, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Boston, MA
National Provider Identifier
1225000623
Registry record updated Feb 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
223504 Issued in MA
Practice address
670 Albany Street
Suite 304
Boston, MA 02118-2646
Phone
(617) 414-5314
Fax
(617) 414-5315
NPI assigned
Feb 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Pathology) Physician 207ZH0000X 223504 MA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 223504 MA Primary

Addresses

Primary practice location

670 Albany Street
Suite 304
Boston, MA 02118-2646

Mailing address

720 Harrison Ave
Dob 503
Boston, MA 02118
Phone (617) 414-5405

Other identifiers 1

IdentifierTypeStateIssuer
110076181AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060413000063 MA Practitioner - Pathology 1557370970 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of New Mexico School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boston University Mallory Pathology Associates IncGroup PAC ID 2062301807, 17 clinicians
Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 414-4291

29 Mall Rd
Burlington, MA 01805-0001

41 Mall Rd
Burlington, MA 01805-0001

670 Albany St
Suite 3
Boston, MA 02118-2653
Phone (617) 414-4291

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
223504MAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston University Mallory Pathology Associates, Inc. Anatomic Pathology & Clinical Pathology CurrentSince Apr 1, 2018 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients
Evans Medical Foundation, Inc. Past Accepting new patients

Locations

670 Albany St
Ste 304
Boston, MA 02118
Phone (617) 414-4291

670 Albany St
Ste 3
Boston, MA 02118
Phone (617) 414-4291

720 Harrison Ave
#503
Roxbury, MA 02118
Phone 6174145404 ext. 2

Interoperability endpoints

  • Direct secure messaging: eburks103704@direct.bmc.masshiway.net
  • Direct secure messaging: eburks11623@direct.bilh.masshiway.net

Organizations & group practices 5

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517443200000",
    "number": "1225000623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE",
            "address_2": "DOB 503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-414-5405",
            "fax_number": "617-414-6031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 ALBANY STREET",
            "address_2": "SUITE 304",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182646",
            "telephone_number": "617-414-5314",
            "fax_number": "617-414-5315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKS",
        "first_name": "ERIC",
        "middle_name": "JASON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2018-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "MA",
            "license": "223504",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MA",
            "license": "223504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110076181A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.