Individual provider Active NPI

George E Burns, MD

  • MOHS-Micrographic Surgery Physician
  • Clearwater, FL
National Provider Identifier
1508858044
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
0032383 Issued in FL
Practice address
1122 Druid Rd E
Clearwater, FL 33756-4100
Phone
(727) 461-2282
NPI assigned
Aug 19, 2005
Last updated
Jan 15, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 0032383 FL Primary
Dermatopathology Physician 207ND0900X ME0032383 FL

Addresses

Primary practice location

1122 Druid Rd E
Clearwater, FL 33756-4100

Mailing address

1122 Druid Rd E
Clearwater, FL 33756-4100
Phone (727) 461-2282

Other identifiers 5

IdentifierTypeStateIssuer
044851600MedicaidFL
77445OtherFLMEDICARE GROUP PROV.
0305003OtherFLUNITED HEALTHCARE
2147510OtherFLAETNA
73270ZOtherFLBCBS PERFORMING PROVIDER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20091107000006 FL Practitioner - Dermatology 0042358392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0032383FLMDMOHS-Micrographic Surgery Physician
ME0032383FLMDDermatopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aqua Dermatology of Florida, PA CurrentSince Jan 16, 2017 Accepting new patients
Naples Center for Dermatology & Riverchase Dermatology CurrentSince Jan 16, 2017 Accepting new patients

Locations

1122 Druid Rd E
Clearwater, FL 33756
Phone (727) 461-2282

15051 S Tamiami Trl
Ste 203
Fort Myers, FL 33908
Phone (239) 732-5959

1015 Crosspointe Dr
Naples, FL 34110
Phone (239) 596-9075

14840 Tamiami Trl
North Port, FL 34287
Phone (941) 564-1542

Interoperability endpoints

  • Direct secure messaging: gburns@aquadermatology.emadirect.md

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": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1508858044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 DRUID RD E",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337564100",
            "telephone_number": "727-461-2282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 DRUID RD E",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337564100",
            "telephone_number": "727-461-2282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNS",
        "first_name": "GEORGE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "0032383",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "FL",
            "license": "ME0032383",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044851600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PROV.",
            "identifier": "77445",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0305003",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2147510",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PERFORMING PROVIDER",
            "identifier": "73270Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.