Samantha Burgess, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

4704350687 Issued in MI

Practice address

145 Michigan St NE Ste 3100
Grand Rapids, MI 49503-2563

Phone

(616) 954-9800

Fax

(616) 954-2116

NPI assigned

Jun 4, 2019

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

Medicare fee-for-service enrollment

Enrolled in MI

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

100 of 100Reported as group

Promoting interoperability

96

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Metropolitan Hospital

  • Internal Medicine Physician
  • Wyoming, MI
  • NPI 1811937519
  Medicare reassignment NPD

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

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1427616580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 FOREMOST DR SE STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467062",
            "telephone_number": "616-954-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 MICHIGAN ST NE STE 3100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032563",
            "telephone_number": "616-954-9800",
            "fax_number": "616-954-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "SAMANTHA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-04",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704350687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Elizabeth Burgess-Dood, PT
• Brandon J Burgess
• Daniel Arthur Burgess, LMSW
• Dorothy Loretta Burgess, M.A.
• Rebecca Burgess
• Scott David Burgess, MD
• Taylor Marie Burgess
• Treasure Burgess
• Gibson Burgett
• Krista Jean Burgett

• Gerontology Nurse Practitioner in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Gerontology Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; 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.