Individual provider Active NPI

Dustin Burnham

  • Anesthesiologist Assistant
  • Melbourne, FL
National Provider Identifier
1346790011
Registry record updated Apr 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
AA586 Issued in FL
Practice address
1350 Hickory St
Melbourne, FL 32901-3224
Phone
(321) 434-7144
NPI assigned
Oct 6, 2016
Last updated
Apr 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X AA586 FL Primary

Addresses

Primary practice location

1350 Hickory St
Melbourne, FL 32901-3224

Mailing address

1775 W Hibiscus Blvd Ste 215
Melbourne, FL 32901-2627
Phone (321) 837-3820

Other practice location 1

1600 SW Archer Rd
Gainesville, FL 32610-5210
Phone (352) 273-8610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161103000066 MO Practitioner - Anesthesiology Assistant 2062790587 Reassigns benefits to 1 organization
I20200917000470 FL Practitioner - Anesthesiology Assistant 2062790587 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indian River Health Services IncGroup PAC ID 9234130329, 335 clinicians

Practice addresses (Care Compare)

1000 36TH St
Suite 244
Vero Beach, FL 32960-4862
Phone (772) 567-4311

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.26 of 100Reported as apm
Quality
80.2
Promoting interoperability
99.24
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
AA586FLMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Apr 10, 2023 Accepting new patients
Brevard Physician Associates, PLLC Anesthesiologist Assistant CurrentSince Sep 25, 2020 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Apr 10, 2023 Accepting new patients
Indian River Health Services Inc CurrentSince Oct 23, 2023 Accepting new patients
Indian River Health Services Inc CurrentSince Oct 23, 2023 Accepting new patients

Locations

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

1775 W Hibiscus Blvd
Ste 215
Melbourne, FL 32901
Phone (321) 255-9671

1000 36th St
Ste 244
Vero Beach, FL 32960
Phone (772) 778-9621

1190 37th St
Vero Beach, FL 32960
Phone (772) 563-4666

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1475712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1346790011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 W HIBISCUS BLVD STE 215",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012627",
            "telephone_number": "321-837-3820",
            "fax_number": "321-837-3654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 HICKORY ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013224",
            "telephone_number": "321-434-7144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326105210",
            "country_code": "US",
            "telephone_number": "352-273-8610",
            "fax_number": "352-273-8612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURNHAM",
        "first_name": "DUSTIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-06",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "AA586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.