Individual provider Active NPI

John D Burgoyne, MD

  • Otolaryngology Physician
  • Austin, TX
National Provider Identifier
1467410613
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD00034623 Issued in WA
Practice address
12201 Renfert Way
Austin, TX 78758-5354
Phone
(512) 277-7500
Fax
(972) 984-1376
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X MD00034623 WA
Plastic and Reconstructive Surgery Physician 2086S0122X MD00034623 WA
Otolaryngology Physician 207Y00000X MD00034623 WA Primary

Addresses

Primary practice location

12201 Renfert Way
Austin, TX 78758-5354

Mailing address

12201 Renfert Way
Austin, TX 78758-5354
Phone (512) 277-7500

Other identifiers 2

IdentifierTypeStateIssuer
8206468MedicaidWA
BU5281OtherWAREGENCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070219000281 WA Practitioner - OtolaryngologyPractitioner - Other (Physician) 0446147136 Reassigns benefits to 1 organization
I20230525002398 TX Practitioner - Otolaryngology 0446147136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Utah School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The ENT and Allergy Centers of Texas, PLLCGroup PAC ID 4385709054, 56 clinicians

Practice addresses (Care Compare)

12201 Renfert Way
245 Austin ENT and Allergy
Austin, TX 78758-5368
Phone (512) 277-7500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00034623WAMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The ENT & Allergy Centers of Texas, PLLC Otolaryngology CurrentSince May 12, 2023 Accepting new patients
Proliance Surgeons Inc P S Current Accepting new patients
Proliance Surgeons Inc P S CurrentSince Apr 4, 2016 Accepting new patients
Proliance Surgeons, Inc., P.S. CurrentSince Apr 4, 2016 Accepting new patients
Richard D Thrasher III MD PA Otolaryngology Past Accepting new patients

Locations

12201 Renfert Way
Ste 245
Austin, TX 78758
Phone (512) 277-7500

5220 W University Dr
Ste 150
McKinney, TX 75071
Phone (972) 632-3270

510 8th Ave NE
Ste 200
Issaquah, WA 98029
Phone (425) 392-3030

3236 78th Ave SE
Ste 200
Mercer Island, WA 98040
Phone (206) 275-5060

515 Minor Ave
Ste 140
Seattle, WA 98104
Phone (206) 682-6103

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

Organizations & group practices 5

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1467410613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 RENFERT WAY",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585354",
            "telephone_number": "512-277-7500",
            "fax_number": "972-984-1376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12201 RENFERT WAY",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585354",
            "telephone_number": "512-277-7500",
            "fax_number": "972-984-1376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGOYNE",
        "first_name": "JOHN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "WA",
            "license": "MD00034623",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "WA",
            "license": "MD00034623",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "MD00034623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8206468",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "BU5281",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.