Individual provider Active NPI

Enrique M Bursztyn, MD

  • Diagnostic Radiology Physician
  • Tucumcari, NM
National Provider Identifier
1669431367
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD2016-0635 Issued in NM
Practice address
301 E Miel de Luna Ave
Tucumcari, NM 88401-3810
Phone
(800) 841-4236
NPI assigned
Mar 21, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 01063267A IN
Diagnostic Radiology Physician 2085R0202X 145707-1 NY
Diagnostic Radiology Physician 2085R0202X 01063267A IN
Diagnostic Radiology Physician 2085R0202X MD2016-0635 NM Primary

Addresses

Primary practice location

301 E Miel de Luna Ave
Tucumcari, NM 88401-3810

Mailing address

PO Box 3212
Indianapolis, IN 46206-3212
Phone (800) 841-4236

Other practice location 1

520 S 7th St
Vincennes, IN 47591-1038
Phone (812) 882-6717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20170711002901 NM Practitioner - Diagnostic Radiology 0547250433 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.28 of 100Reported as group
Quality
90
Improvement activities
40
Cost
77.05

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01063267AINMDDiagnostic Radiology Physician
145707-1NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Imaging LLC Diagnostic Radiology CurrentSince Jun 1, 2017 Accepting new patients
Radiology Associates of Albuquerque, PA Diagnostic Radiology CurrentSince Jun 1, 2017 Accepting new patients
Northfield Imaging Center PA Diagnostic Radiology Past Accepting new patients
Yonkers Imaging PC Diagnostic Radiology Past Accepting new patients
Regional Radiology Associates, PC Diagnostic Radiology Past Accepting new patients
Medical Imaging Center LLP Past Accepting new patients
Magnetic Diagnostic Resources of Central New York, LLP PastSince Jul 1, 1999 Accepting new patients
Advanced Imaging LLC Past Accepting new patients
Cortland Memorial Radiology, PC Diagnostic Radiology Past Accepting new patients

Locations

2400 Unser Blvd SE
Ste 29200
Albuquerque, NM 87124

4411 The 25 Way NE
Ste 150
Albuquerque, NM 87109
Phone (505) 332-5800

700 Lomas Blvd NE
Albuquerque, NM 87102
Phone (505) 242-1711

301 E Miel de Luna Ave
Tucumcari, NM 88401
Phone (575) 461-7000

Organizations & group practices 9

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": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1669431367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3212",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462063212",
            "telephone_number": "800-841-4236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E MIEL DE LUNA AVE",
            "city": "TUCUMCARI",
            "state": "NM",
            "postal_code": "884013810",
            "telephone_number": "800-841-4236"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 S 7th St",
            "address_purpose": "LOCATION",
            "city": "Vincennes",
            "state": "IN",
            "postal_code": "475911038",
            "country_code": "US",
            "telephone_number": "812-882-6717",
            "fax_number": "812-882-8620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURSZTYN",
        "first_name": "ENRIQUE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "IN",
            "license": "01063267A",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "145707-1",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01063267A",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NM",
            "license": "MD2016-0635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucumcari, NM

Sources for this page

Verify at the official NPI Registry.