Individual provider Active NPI

Matthew J Burnett, PA

  • Surgical Physician Assistant
  • East Syracuse, NY
National Provider Identifier
1467457440
Registry record updated Nov 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
009606 Issued in NY
Practice address
6620 Fly Road
Ste 200
East Syracuse, NY 13057
Phone
(315) 464-4472
NPI assigned
Jun 16, 2005
Last updated
Nov 30, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 009606 NY Primary

Addresses

Primary practice location

6620 Fly Road
Ste 200
East Syracuse, NY 13057

Mailing address

6620 Fly Road
Ste 200
East Syracuse, NY 13057
Phone (315) 464-4472

Other identifiers 1

IdentifierTypeStateIssuer
02720189MedicaidNY

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
I20040405001668 NY Practitioner - Physician Assistant 6204829302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upstate Orthopedics, LLPGroup PAC ID 1456344514, 33 clinicians

Practice addresses (Care Compare)

208 Township Blvd
Suite 200
Camillus, NY 13031-1674
Phone (315) 551-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.43 of 100Reported as group
Quality
90.7
Promoting interoperability
100
Improvement activities
40
Cost
80.73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009606NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Orthopedics, LLP CurrentSince Sep 11, 2003 Accepting new patients
Upstate Orthopedics, LLP CurrentSince Sep 11, 2003 Accepting new patients
Murray and Wray Past Accepting new patients

Locations

208 Township Blvd
Ste 200
Camillus, NY 13031
Phone (315) 464-4472

6620 Fly Rd
Ste 100
East Syracuse, NY 13057
Phone (315) 464-4472

6620 Fly Rd
Ste 200
East Syracuse, NY 13057
Phone (315) 464-4472

102 W Seneca St
Ste 110
Manlius, NY 13104
Phone (315) 464-2211

Interoperability endpoints

  • Direct secure messaging: mburnett13752@direct.upstate.edu

Organizations & group practices 3

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.

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259539200000",
    "number": "1467457440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6620 FLY ROAD",
            "address_2": "STE 200",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "13057",
            "telephone_number": "315-464-4472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6620 FLY ROAD",
            "address_2": "STE 200",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "13057",
            "telephone_number": "315-464-4472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETT",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2009-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "009606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02720189",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

Verify at the official NPI Registry.