Active NPI
Mary E Burke, NP
- Nurse Practitioner
- Worcestor, MA
National Provider Identifier
1255311270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 200883
- Practice address
- 630 Plantation St
Worcestor, MA 01605 - Phone
- (508) 595-2000
- Fax
- (508) 853-7149
- NPI assigned
- Jan 17, 2006
- Last updated
- Jan 28, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 200883 | MA | Primary |
Addresses
Primary practice location
630 Plantation St
Worcestor, MA 01605
Mailing address
630 Plantation St
Worcestor, MA 01605
Phone (508) 595-2000
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 042472266 | Other | PRIVATE HEALTHCARE SYSTEM | |
| 0700380 | Medicaid | MA | |
| 8300309 | Other | EVERCARE | |
| AA3454 | Other | HARVARD PILGRIM HEALTHCAR | |
| NP0719 | Other | BLUE SHIELD INDEMNITY | |
| NP0719 | Other | BLUE CARE ELECT | |
| 04247226 | Other | ONE HEALTH PLAN | |
| 042472266 | Other | THREE RIVERS | |
| NP0719 | Other | MEDICARE B | |
| 500002311 | Other | RAILROAD MEDICARE | |
| NP0719 | Other | BLUE SHIELD HMO BLUE | |
| 042472266008 | Other | TRICARE/CHAMPUS | |
| 57692 | Other | FALLON COMMUNITY HEALTH P |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200883 | MA | MD | Nurse Practitioner |
Interoperability endpoints
- mary.burke.p1@direct.fallonhealth.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233100800000",
"number": "1255311270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 PLANTATION ST",
"city": "WORCESTOR",
"state": "MA",
"postal_code": "01605",
"telephone_number": "508-595-2000",
"fax_number": "508-853-7149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 PLANTATION ST",
"city": "WORCESTOR",
"state": "MA",
"postal_code": "01605",
"telephone_number": "508-595-2000",
"fax_number": "508-853-7149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURKE",
"first_name": "MARY",
"middle_name": "E",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-17",
"last_updated": "2009-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MA",
"license": "200883",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIVATE HEALTHCARE SYSTEM",
"identifier": "042472266",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0700380",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EVERCARE",
"identifier": "8300309",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM HEALTHCAR",
"identifier": "AA3454",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD INDEMNITY",
"identifier": "NP0719",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CARE ELECT",
"identifier": "NP0719",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ONE HEALTH PLAN",
"identifier": "04247226",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "THREE RIVERS",
"identifier": "042472266",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE B",
"identifier": "NP0719",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "500002311",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD HMO BLUE",
"identifier": "NP0719",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE/CHAMPUS",
"identifier": "042472266008",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FALLON COMMUNITY HEALTH P",
"identifier": "57692",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Worcestor, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.