Individual provider Active NPI

Jason Burley, PA-C

  • Physician Assistant
  • Dublin, OH
National Provider Identifier
1376428433
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
6805 Bobcat Way Ste 112
Dublin, OH 43016-1681
Phone
(614) 793-5619
NPI assigned
Aug 7, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OH Primary

Addresses

Primary practice location

6805 Bobcat Way Ste 112
Dublin, OH 43016-1681

Mailing address

6805 Bobcat Way Ste 112
Dublin, OH 43016-1681
Phone (614) 793-5619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20251208002889 OH Practitioner - Physician Assistant 6800380817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

3533 Southern Blvd
Suite 2100
Kettering, OH 45429-1267
Phone 93739585561267

Hospital & facility affiliations

  • Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc CurrentSince Jan 15, 2026 Accepting new patients

Locations

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

3533 Southern Blvd
Ste 2100
Kettering, OH 45429
Phone (937) 293-3486

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 and National Provider Directory roles.

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": "1754524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1376428433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6805 BOBCAT WAY STE 112",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430161681",
            "telephone_number": "614-793-5619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6805 BOBCAT WAY STE 112",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430161681",
            "telephone_number": "614-793-5619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURLEY",
        "first_name": "JASON",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-07",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

Verify at the official NPI Registry.