Individual provider Active NPI

Annette Marcia Burgess, NP

  • Adult Health Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1285407858
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
311617 Issued in NY
Practice address
585 Schenectady Ave
Brooklyn, NY 11203-1822
Phone
(718) 604-5000
NPI assigned
Nov 6, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2200X 311617 NY Primary

Addresses

Primary practice location

585 Schenectady Ave
Brooklyn, NY 11203-1822

Mailing address

18836 114TH Dr
Saint Albans, NY 11412-2611
Phone (646) 241-2766

Other names 1

  • Mrs. Annette Marcia Burgess-Robinson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240215003494 NY Practitioner - Nurse Practitioner 4688018823 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
311617NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ilm Medical Care PLLC Single Specialty CurrentSince Jan 6, 2024 Accepting new patients

Locations

600 E Crescent Ave
Ste 305
Upper Saddle River, NJ 07458

2975 Independence Ave
Bronx, NY 10463
Phone (718) 542-1700

11909 26th Ave
Flushing, NY 11354
Phone (718) 434-0600

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.

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1285407858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18836 114TH DR",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "114122611",
            "telephone_number": "646-241-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 SCHENECTADY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031822",
            "telephone_number": "718-604-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "ANNETTE",
        "middle_name": "MARCIA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "311617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNETTE",
            "last_name": "BURGESS-ROBINSON",
            "middle_name": "MARCIA",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.