NPIMap

Individual provider Active NPI

Jeffrey Daniel Burry, D.O.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Lewiston, ID
National Provider Identifier
1275698367
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
O-337 Issued in ID
Practice address
330 Warner Dr
Lewiston, ID 83501-4441
Phone
(208) 746-0193
Fax
(208) 746-7074
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X OP00001929 WA
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X O-337 ID Primary

Addresses

Primary practice location

330 Warner Dr
Lewiston, ID 83501-4441

Mailing address

330 Warner Dr
Lewiston, ID 83501-4441
Phone (208) 746-0193

Other identifiers 4

IdentifierTypeStateIssuer
55098OtherBLUECROSS OF IDAHO
8398166MedicaidWA
000010147208OtherREGENCE BLUESHIELD OF ID
806910700MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040806000513 WA Practitioner - Otolaryngology 5698662229 Reassigns benefits to 1 organization
I20040806001198 ID Practitioner - Otolaryngology 5698662229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Philadelphia College of Osteopathic Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Facial Plastics and ENT, PAGroup PAC ID 0840197166, 2 clinicians

Practice addresses (Care Compare)

1221 Highland Ave
Clarkston, WA 99403-2829
Phone (509) 758-5511

318 Warner Dr
Lewiston, ID 83501-4441
Phone (208) 298-1050

330 Warner Dr
Lewiston, ID 83501-4441
Phone (208) 746-0193

Hospital & facility affiliations

  • Tri-State Memorial Hospital Hospital, Clarkston, WA, CCN 501332
  • St Joseph Regional Medical Center Hospital, Lewiston, ID, CCN 130003
  • Clearwater Valley Hospital & Clinics Hospital, Orofino, ID, CCN 131320

Merit-based Incentive Payment System (MIPS)

Final score
72.76 of 100Reported as individual
Quality
81.95
Improvement activities
40
Cost
33.27

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision224
Removal of skin lesions44
Removal or shaving of skin growth113

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
O-337IDMDOtolaryngology/Facial Plastic Surgery Physician

Interoperability endpoints

  • Direct secure messaging: jeffrey.burry.p1@direct.vent.nextgenshare.com

Organizations & group practices 1

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 9

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

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1275698367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 WARNER DR",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014441",
            "telephone_number": "208-746-0193",
            "fax_number": "208-746-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 WARNER DR",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014441",
            "telephone_number": "208-746-0193",
            "fax_number": "208-746-7074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRY",
        "first_name": "JEFFREY",
        "middle_name": "DANIEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "WA",
            "license": "OP00001929",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "ID",
            "license": "O-337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS OF IDAHO",
            "identifier": "55098",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8398166",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUESHIELD OF ID",
            "identifier": "000010147208",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806910700",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

Verify at the official NPI Registry.