Individual provider Active NPI

Chutima S Burham, AANP

  • Adult Health Nurse Practitioner
  • Jamestown, NY
National Provider Identifier
1588420517
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F311694-01 Issued in NY
Practice address
15 S Main St
Jamestown, NY 14701-6626
Phone
(716) 664-7725
NPI assigned
Feb 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F311694-01 NY Primary

Addresses

Primary practice location

15 S Main St
Jamestown, NY 14701-6626

Mailing address

5474 Route 474
Ashville, NY 14710-9555
Phone (818) 915-3388

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address chutima.s.burham@upmcdirect.com

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
I20240503001267 NY Practitioner - Nurse Practitioner 1153761457 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
Group practices
Great Lakes Physician Practice PCGroup PAC ID 6709007701, 143 clinicians

Practice addresses (Care Compare)

15 S Main St
Suite 150
Jamestown, NY 14701-6627
Phone (814) 484-8610

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F311694-01NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jamestown Area Medical Associates, L.L.P. Adult Health CurrentSince Jun 1, 1997 Accepting new patients
Great Lakes Physician Practice PC CurrentSince Apr 1, 2024 Accepting new patients

Locations

15 S Main St
Jamestown, NY 14701
Phone (607) 846-2030

15 S Main St
Ste 150
Jamestown, NY 14701
Phone (716) 483-6700

31 Sherman St
Ste 2400
Jamestown, NY 14701
Phone (814) 483-5306

2 Hot Metal St
Fl 3
Pittsburgh, PA 15203
Phone (412) 432-5869

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1708992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1588420517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5474 ROUTE 474",
            "city": "ASHVILLE",
            "state": "NY",
            "postal_code": "147109555",
            "telephone_number": "818-915-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 S MAIN ST",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016626",
            "telephone_number": "716-664-7725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURHAM",
        "first_name": "CHUTIMA",
        "middle_name": "S",
        "credential": "AANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-27",
        "last_updated": "2024-08-21",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F311694-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chutima.s.burham@upmcdirect.com",
            "affiliation": "N",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jamestown, NY

Sources for this page

Verify at the official NPI Registry.