Individual provider Active NPI

Kraig M Burgess, D.O.

  • Orthopaedic Hand Surgery Physician
  • Glendale, AZ
National Provider Identifier
1396735882
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
4169 Issued in AZ
Practice address
18555 N 79TH Ave Ste E101
Glendale, AZ 85308-8392
Phone
(602) 648-5444
Fax
(602) 772-3801
NPI assigned
Oct 25, 2005
Last updated
Jul 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 4169 AZ
Orthopaedic Hand Surgery Physician 207XS0106X 4169 AZ Primary

Addresses

Primary practice location

18555 N 79TH Ave Ste E101
Glendale, AZ 85308-8392

Mailing address

PO Box 80217
Phoenix, AZ 85060-0217
Phone (602) 385-2115

Other identifiers 1

IdentifierTypeStateIssuer
954348MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20050428000168 AZ Practitioner - Hand Surgery 1850330002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hand Surgery
Education
Ohio University, College of Osteopathic Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BHSM Rehabilitation LLCGroup PAC ID 2062773138, shared by 27 NPIs, 450 clinicians

Practice addresses (Care Compare)

25101 N Lake Pleasant Pkwy
Suite B 1340
Peoria, AZ 85383-1386
Phone (602) 610-6866

2940 E Banner Gateway Dr
Gilbert, AZ 85234-2168

5620 E Bell Rd
Scottsdale, AZ 85254-5950
Phone (602) 385-2115

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4169AZMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Specialists of North America, PLLC Orthopaedic Surgery CurrentSince Feb 1, 2019 Accepting new patients
Orthopedic Specialists of North America, PLLC Orthopaedic Surgery Current Accepting new patients

Locations

18555 N 79th Ave
Ste E101
Glendale, AZ 85308
Phone (602) 631-3161

3033 N 44th St
Ste 100
Phoenix, AZ 85018
Phone (602) 631-3161

9327 N 3rd St
Ste 300
Phoenix, AZ 85020
Phone (602) 944-0181

5620 E Bell Rd
Scottsdale, AZ 85254
Phone (602) 485-3050

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

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1396735882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80217",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850600217",
            "telephone_number": "602-385-2115",
            "fax_number": "480-418-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18555 N 79TH AVE STE E101",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088392",
            "telephone_number": "602-648-5444",
            "fax_number": "602-772-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "KRAIG",
        "middle_name": "M",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "4169",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "AZ",
            "license": "4169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "954348",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.