Individual provider Active NPI

Christopher Burkett, P.A.

  • Physician Assistant
  • Costa Mesa, CA
National Provider Identifier
1629258447
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA19407 Issued in CA
Practice address
1550 Superior Ave
Costa Mesa, CA 92627-3653
Phone
(949) 650-0640
NPI assigned
Nov 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA19407 CA Primary

Addresses

Primary practice location

1550 Superior Ave
Costa Mesa, CA 92627-3653

Mailing address

780 Rosecrans Ave
Manhattan Beach, CA 90266-3462
Phone (310) 918-1944

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20081219000005 CA Practitioner - Physician Assistant 3577625904 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA19407CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vepema Medical Group Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198022400000",
    "number": "1629258447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 ROSECRANS AVE",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902663462",
            "telephone_number": "310-918-1944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 SUPERIOR AVE",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273653",
            "telephone_number": "949-650-0640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKETT",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-08",
        "last_updated": "2007-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA19407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.