Individual provider Active NPI

Patrick Burnett, MD

  • Dermatology Physician
  • Chatham, NJ
National Provider Identifier
1225125347
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
25MA12033900 Issued in NJ
Practice address
417 Main St
Chatham, NJ 07928-2105
Phone
(973) 635-5050
NPI assigned
Oct 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 227814 NY
Dermatology Physician 207N00000X MD38907 TN
Dermatology Physician 207N00000X 25MA12033900 NJ Primary

Addresses

Primary practice location

417 Main St
Chatham, NJ 07928-2105

Mailing address

417 Main St
Chatham, NJ 07928-2105
Phone (973) 635-5050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20240201004353 NJ Practitioner - Dermatology 3173584414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2000
Medicare assignment
May accept Medicare assignment
Group practices
Laser and Skin Therapeutics PCGroup PAC ID 9234224874, 4 clinicians

Practice addresses (Care Compare)

417 Main St
Chatham, NJ 07928-2105
Phone (973) 635-5050

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions98
Skin biopsy22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA12033900NJMDDermatology Physician
227814NYMDDermatology Physician
MD38907TNMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Laser & Skin Therapeutics PC Dermatology CurrentSince Feb 1, 2024 Accepting new patients
Chatham Chiropractic Center PastSince Jan 7, 2024 Accepting new patients

Locations

417 Main St
Chatham, NJ 07928
Phone (973) 635-2290

Organizations & group practices 2

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": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1225125347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 MAIN ST",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079282105",
            "telephone_number": "973-635-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 MAIN ST",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079282105",
            "telephone_number": "973-635-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETT",
        "first_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-09",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "227814",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TN",
            "license": "MD38907",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "25MA12033900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chatham, NJ

Sources for this page

Verify at the official NPI Registry.