B Geoffrey Burnham, PA-C
Individual provider Active NPI Physician Assistant · East Lyme, CT
NPI 1235112418 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1235112418
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 000080 (CT)
- Practice address
- 324 Flanders Rd
East Lyme, CT 06333-1735 - Phone
- (860) 739-6953
- Fax
- (860) 739-2523
- NPI assigned
- Nov 22, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Wake Forest University School of Medicine, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northeast Medical Group Inc
Practice addresses (Care Compare)
248 Flanders Rd
Niantic, CT 06357-1264
Phone (860) 739-5426
49 Sandy Desert Rd
Uncasville, CT 06382-1111
Phone (860) 862-7329
67 Sandy Desert Rd
Uncasville, CT 06382-1111
Phone (860) 464-3800
91 Voluntown Rd
Pawcatuck, CT 06379-1366
Phone (860) 599-5477
95 Armory Rd
Stratford, CT 06614-1702
Phone (203) 384-3388
Hospital & facility affiliations
- Lawrence & Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 86.54
- Promoting interoperability
- 99.98
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120601000099 | CT | Practitioner - Physician Assistant | 4486817467 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000080 | CT | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern Council on Alcoholism and Drug Dependence Inc | Current |
Accepting new patients | |
| Northeast Medical Group, Inc. | Current |
Accepting new patients | |
| Mill Hill Medical Consultants Inc | Current |
Accepting new patients | |
| Country Doc Walk-in &Wellness LLC | Past | Accepting new patients |
Locations
23 Clara Dr
Mystic, CT 06355
Phone (860) 443-7907
248 Flanders Rd
Niantic, CT 06357
Phone (860) 739-5426
91 Voluntown Rd
Pawcatuck, CT 06379
Phone (860) 599-5477
95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388
2 Sandy Desert Rd
Uncasville, CT 06382
Phone (860) 464-3800
Interoperability endpoints
- bburnham429122@direct.ynhh.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 000080 | CT | Yes |
Addresses
Primary practice location
324 Flanders Rd
East Lyme, CT 06333-1735
Mailing address
324 Flanders Rd
East Lyme, CT 06333-1735
Phone (860) 739-6953
Other providers in East Lyme, CT
- William L Beason
- Arnold Emery Benak Jr.
- Caitlin Blackburn
- Amy Blodgett
- Renee Ann Brown
- Thomas J. Butcher
- Alijah Brooke Cafro
- Leah Cagney-Vella
- Katie Camann
- Lindsay Capone
All providers in East Lyme, CT · Physician Assistant in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.