Individual provider Active NPI

Tiffany Burro

  • Psychiatric/Mental Health Nurse Practitioner
  • Medford, NY
National Provider Identifier
1417745951
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
406368 Issued in NY
Practice address
1727 N Ocean Ave
Medford, NY 11763-2649
Phone
(631) 804-0769
NPI assigned
Apr 25, 2025
Last updated
Dec 18, 2025By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 406368 NY Primary

Addresses

Primary practice location

1727 N Ocean Ave
Medford, NY 11763-2649

Mailing address

44 W Greentree Dr
Medford, NY 11763-1690

Other practice location 1

21 4th Ave
Bay Shore, NY 11706-7908
Phone (631) 665-6707

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251007001694 NY Practitioner - Nurse Practitioner 9830696996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

21 4TH Ave
Bay Shore, NY 11706-7908
Phone (631) 665-6707

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
406368NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities of the Diocese of Rockville Centre CurrentSince Oct 1, 2025 Accepting new patients
Catholic Charities of the Diocese of Rockville Centre CurrentSince Oct 1, 2025 Accepting new patients

Locations

21 4th Ave
Bay Shore, NY 11706
Phone (631) 665-6707

90 Cherry Ln
Hicksville, NY 11801
Phone (516) 733-7040

1727 N Ocean Ave
Medford, NY 11763
Phone (631) 684-1919

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": "1745539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1417745951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 W GREENTREE DR",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117631690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 N OCEAN AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632649",
            "telephone_number": "631-804-0769"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 4th Ave",
            "address_purpose": "LOCATION",
            "city": "Bay Shore",
            "state": "NY",
            "postal_code": "117067908",
            "country_code": "US",
            "telephone_number": "631-665-6707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURRO",
        "first_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-04-25",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "406368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NY

Sources for this page

Verify at the official NPI Registry.