Individual provider Active NPI

Geoffrey W Burnham, MD

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1336430776
Registry record updated Mar 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
Q2645 Issued in TX
Practice address
12221 Merit Drive
Suite 1500
Dallas, TX 75251-2202
Phone
(214) 217-1911
Fax
(214) 217-1912
NPI assigned
Apr 20, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X Q2645 TX Primary

Addresses

Primary practice location

12221 Merit Drive
Suite 1500
Dallas, TX 75251-2202

Mailing address

12221 Merit Drive
Suite 1500
Dallas, TX 75251-2202
Phone (214) 217-1911

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150324000918 TX Practitioner - Internal Medicine 9335361773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Questcare Hospitalists PLLCGroup PAC ID 5799785119, 266 clinicians

Practice addresses (Care Compare)

1950 Record Crossing Rd
Dallas, TX 75235-6223
Phone (954) 939-5000

2301 Marsh LN
Plano, TX 75093-8497
Phone (954) 939-5000

3600 Mapleshade LN
Plano, TX 75075-5715
Phone (469) 830-2350

401 W Campbell Rd
FL 5
Richardson, TX 75080-3416
Phone (469) 872-9200

7777 Forest LN
Dallas, TX 75230-2571
Phone (972) 566-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q2645TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Questcare Hospitalists PLLC Internal Medicine CurrentSince Mar 1, 2015 Accepting new patients
Columbia Hospital at Medical City Dallas Subsidiary LP Past Accepting new patients

Locations

2601 W Randol Mill Rd
Arlington, TX 76012
Phone (817) 274-5571

1950 Record Crossing Rd
Dallas, TX 75235
Phone (214) 638-1500

12221 Merit Dr
Ste 1500
Dallas, TX 75251
Phone (214) 217-1900

2301 Marsh Ln
Plano, TX 75093
Phone (972) 428-1600

Organizations & group practices 2

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 2

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": "1303257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425427200000",
    "number": "1336430776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12221 MERIT DRIVE",
            "address_2": "SUITE 1500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752512202",
            "telephone_number": "214-217-1911",
            "fax_number": "214-217-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12221 MERIT DRIVE",
            "address_2": "SUITE 1500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752512202",
            "telephone_number": "214-217-1911",
            "fax_number": "214-217-1912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNHAM",
        "first_name": "GEOFFREY",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-20",
        "last_updated": "2015-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q2645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.