Individual provider Active NPI

Ananias Motta Burgos

  • Obstetrics & Gynecology Physician
  • Michigan City, IN
National Provider Identifier
1225663552
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
01100356A Issued in IN
Practice address
3500 Franciscan Way Ste 300
Michigan City, IN 46360-0033
Phone
(219) 861-8785
Fax
(219) 861-8789
NPI assigned
Mar 6, 2020
Last updated
Sep 1, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Obstetrics & Gynecology Physician 207V00000X 01100356A IN Primary

Addresses

Primary practice location

3500 Franciscan Way Ste 300
Michigan City, IN 46360-0033

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

2201 Hempstead Tpke
East Meadow, NY 11554-1859
Phone (516) 296-2830

Other practice location 2

Carr 164 KM 13.7 Corozal P.R
Corozal, PR 00783-9671
Phone (787) 515-2426

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

200 Carman Ave
Apt 5C
East Meadow, NY 11554-1150

2201 Hempstead Tpke
East Meadow, NY 11554-5400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1583452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1225663552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 FRANCISCAN WAY STE 300",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463600033",
            "telephone_number": "219-861-8785",
            "fax_number": "219-861-8789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2201 Hempstead Tpke",
            "address_purpose": "LOCATION",
            "city": "East Meadow",
            "state": "NY",
            "postal_code": "115541859",
            "country_code": "US",
            "telephone_number": "516-296-2830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Carr 164 KM 13.7 Corozal P.R",
            "address_purpose": "LOCATION",
            "city": "Corozal",
            "state": "PR",
            "postal_code": "007839671",
            "country_code": "US",
            "telephone_number": "787-515-2426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOTTA BURGOS",
        "first_name": "ANANIAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-06",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01100356A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

Verify at the official NPI Registry.