Individual provider Active NPI

John James Burnett, DO

  • Family Medicine Physician
  • Evans Mills, NY
National Provider Identifier
1366892846
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
300258 Issued in NY
Practice address
26908 Independence Way
Evans Mills, NY 13637-3300
Phone
(315) 629-4525
Fax
(315) 629-5751
NPI assigned
Jun 15, 2016
Last updated
May 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 300258 NY Primary

Addresses

Primary practice location

26908 Independence Way
Evans Mills, NY 13637-3300

Mailing address

26908 Independence Way
Evans Mills, NY 13637-3300
Phone (315) 629-4525

Other practice location 1

830 Washington St
Watertown, NY 13601-4034
Phone (315) 786-7300

Other identifiers 1

IdentifierTypeStateIssuer
05863332MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191014002038 NY Practitioner - Family Practice 4880925312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Samaritan Medical CenterGroup PAC ID 8123914876, 157 clinicians

Practice addresses (Care Compare)

26908 Independence Way
Evans Mills, NY 13637-3300
Phone (315) 629-4525

Hospital & facility affiliations

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: john.burnett@sfhcny.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1366892846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26908 INDEPENDENCE WAY",
            "city": "EVANS MILLS",
            "state": "NY",
            "postal_code": "136373300",
            "telephone_number": "315-629-4525",
            "fax_number": "315-629-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26908 INDEPENDENCE WAY",
            "city": "EVANS MILLS",
            "state": "NY",
            "postal_code": "136373300",
            "telephone_number": "315-629-4525",
            "fax_number": "315-629-5751"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "830 Washington St",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "NY",
            "postal_code": "136014034",
            "country_code": "US",
            "telephone_number": "315-786-7300",
            "fax_number": "315-786-7310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURNETT",
        "first_name": "JOHN",
        "middle_name": "JAMES",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-15",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "300258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05863332",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans Mills, NY

Sources for this page

Verify at the official NPI Registry.