Amy-Jo Lavay Burroughs, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

010035 Issued in NY

Practice address

1 School St
Suite 107
Gowanda, NY 14070-1133

Phone

(716) 241-7067

Fax

(716) 241-7197

NPI assigned

Apr 17, 2006

Last updated

Jun 23, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Merit-based Incentive Payment System (MIPS)

Final score

89 of 100Reported as group

Quality

76.13

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• University Emergency Medical Services Inc.

  • Emergency Medicine Physician
  • Buffalo, NY
  • NPI 1972540482
  Medicare reassignment
• Ub Family Medicine, Inc

  dba UBMD Primary Care

  • Family Medicine Physician
  • Williamsville, NY
  • NPI 1942294467
  NPD
• The Chautauqua Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Dunkirk, NY
  • NPI 1760747521
  NPD (past)

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403481600000",
    "number": "1366406134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SCHOOL STREET",
            "address_2": "SUITE 107",
            "city": "GOWANDA",
            "state": "NY",
            "postal_code": "140701133",
            "telephone_number": "716-241-7067",
            "fax_number": "716-241-7197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SCHOOL ST",
            "address_2": "SUITE 107",
            "city": "GOWANDA",
            "state": "NY",
            "postal_code": "140701133",
            "telephone_number": "716-241-7067",
            "fax_number": "716-241-7197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURROUGHS",
        "first_name": "AMY-JO",
        "middle_name": "LAVAY",
        "name_prefix": "Ms.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2014-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "010035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02626126",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF TRANSPORTATION",
            "identifier": "6209596955",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Priscilla Joan Adams, DDS
• Dana P Anderson, M.D.
• Brooks - TLC Hospital System Inc
• Brooks - TLC Hospital System, Inc.
• Whitney Kay Brooks, RDN
• Deanna Louise Camizzi, O.T.R.
• Darlene Ann Capozzi, RN
• Harrison Benjamin Civin, RPH
• Ann Marie Cobo, LPN
• Vincent J Coniglio

• Physician Assistant in Gowanda, NY
• Providers in Gowanda, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.