Chanele M Burgun, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

217557 Issued in NY

Practice address

212 Highbridge St C
Fayetteville, NY 13066-1981

Phone

(315) 637-0477

Fax

(315) 637-0559

NPI assigned

Dec 29, 2005

Last updated

Oct 8, 2015By the provider in NPPES

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 NY

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

Specialty

Family Practice

Education

Howard University College of Medicine, 1997

Medicare assignment

May accept Medicare assignment

Group practices

Select PT, OT and SLP Rehabilitation Ny, PLLCGroup PAC ID 3870986656, 261 clinicians

Errol S McKenzie MD PLLCGroup PAC ID 4880728138, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Samaritan Medical Center Hospital, Watertown, NY, CCN 330157
• University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241
• Oneida Health Hospital Hospital, Oneida, NY, CCN 330115

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: chanele.burgun.1@8712.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/8712/brand/1/csg/1/fhir/r4

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.

• Errol S McKenzie MD PLLC

  dba Family Medicine Associates of Fayetteville

  • Family Medicine Physician
  • Fayetteville, NY
  • NPI 1023322286
  Medicare reassignment Care Compare group NPD
• Select PT, OT & SLP Rehabilitation Ny PLLC

  • Rehabilitation Clinic/Center
  • Jamesville, NY
  • NPI 1457026353
  Care Compare group
• Genesee Valley Group Health Association

  dba Lifetime Health Medical Group

  • Clinic Pharmacy
  • Rochester, NY
  • NPI 1962591875
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Oneida Health Systems, Inc

  dba Oneida Healthcare Center

  • General Acute Care Hospital
  • Oneida, NY
  • NPI 1962408203
  Care Compare affiliation
• Samaritan Medical Center

  • General Acute Care Hospital
  • Watertown, NY
  • NPI 1598713745
  Care Compare affiliation
• Suny Health Science Center at Syracuse

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1578554630
  Care Compare affiliation

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444262400000",
    "number": "1619954823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 HIGHBRIDGE ST C",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661981",
            "telephone_number": "315-637-0477",
            "fax_number": "315-637-0559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 HIGHBRIDGE ST C",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661981",
            "telephone_number": "315-637-0477",
            "fax_number": "315-637-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGUN",
        "first_name": "CHANELE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2015-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "217557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenaye Karin Broe, FNP-C
• Dana Rae Brompton, DDS
• Vadjista Broumand, MD
• Edith P Brown, LMHC
• Joseph Bulone
• Jessica A Burt, PT, DPT
• Cornelia Maria Buur, M.S.W.
• Joseph L Byrne, MD
• Michael F Cadin, D.D.S.
• Robert Cady, MD

• Family Medicine Physician in Fayetteville, NY
• Providers in Fayetteville, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; 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.