Individual provider Active NPI

Alexandra Demetria McBurnie, OD

  • Optometrist
  • Chesterton, IN
National Provider Identifier
1306498787
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18004255A Issued in IN
Practice address
101 Beverly Dr Ste C
Chesterton, IN 46304-3471
Phone
(219) 728-3937
NPI assigned
Jul 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT-002367 AZ
Optometrist 152W00000X 18004255A IN Primary

Addresses

Primary practice location

101 Beverly Dr Ste C
Chesterton, IN 46304-3471

Mailing address

4315 Campbell St
Valparaiso, IN 46385-1301
Phone (812) 345-0602

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210423000073 IN Practitioner - Optometry 4587072921 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

101 Beverly Dr
Suite C
Chesterton, IN 46304-3471
Phone (219) 728-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT-002367AZMDOptometrist
18004255AINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northshore Health Centers Inc Current Accepting new patients
Northshore Health Centers, Inc. CurrentSince Nov 18, 2021 Accepting new patients
J&a McBurnie, LLC Optometrist CurrentSince Sep 27, 2025 Accepting new patients
Northshore Health Centers, Inc. Optometrist CurrentSince Nov 18, 2021 Accepting new patients
Duneland Family Eyecare LLC Optometrist PastSince Jul 13, 2025 Accepting new patients

Locations

101 Beverly Dr
Ste C
Chesterton, IN 46304
Phone (219) 381-7208

6050 Sterling Creek Rd
Portage, IN 46368
Phone (219) 212-0188

Interoperability endpoints

  • Direct secure messaging: alexandra.kossis.p1@direct.northshorehealth.nextgenshare.com

Organizations & group practices 5

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": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1306498787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4315 CAMPBELL ST",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463851301",
            "telephone_number": "812-345-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BEVERLY DR STE C",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463043471",
            "telephone_number": "219-728-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBURNIE",
        "first_name": "ALEXANDRA",
        "middle_name": "DEMETRIA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002367",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004255A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterton, IN

Sources for this page

Verify at the official NPI Registry.