Individual provider Active NPI

Jeffrey B Burl, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Worcester, MA
National Provider Identifier
1699749309
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
43815 Issued in MA
Practice address
630 Plantation St
Worcester, MA 01605
Phone
(508) 595-2000
Fax
(508) 853-7149
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 43815 MA Primary

Addresses

Primary practice location

630 Plantation St
Worcester, MA 01605

Mailing address

630 Plantation St
Wot 12TH Floor Attn. Physician Services
Worcester, MA 01605
Phone (508) 595-2000

Other identifiers 8

IdentifierTypeStateIssuer
9900150OtherFALLON COMMUNITY HLTH PLN
E38004OtherMEDICARE B
0400884OtherEVERCARE
4580406OtherAETNA US HEALTHCARE
2097559MedicaidMA
5952616OtherCIGNA HEALTH PLAN
AA2837OtherHARVARD PILGRIM HEALTHCRE
2097559OtherMEDICAID WELFARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20100212000315 MA Practitioner - Geriatric Medicine 5395889406 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43815MAMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc Geriatric Medicine CurrentSince Jul 1, 1984 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

630 Plantation St
Worcester, MA 01605
Phone (508) 368-5529

385 Grove St
Worcester, MA 01605
Phone (508) 453-8802

630 Plantation St
Fl 12
Worcester, MA 01605
Phone (508) 368-5529

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

Interoperability endpoints

  • Direct secure messaging: jeffrey.burl.npi1699749309.reliant@direct.optumcare.masshiway.net

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699749309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 PLANTATION ST",
            "address_2": "WOT 12TH FLOOR ATTN. PHYSICIAN SERVICES",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01605",
            "telephone_number": "508-595-2000",
            "fax_number": "508-853-7149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 PLANTATION ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01605",
            "telephone_number": "508-595-2000",
            "fax_number": "508-853-7149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURL",
        "first_name": "JEFFREY",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MA",
            "license": "43815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON COMMUNITY HLTH PLN",
            "identifier": "9900150",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE B",
            "identifier": "E38004",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "0400884",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "4580406",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2097559",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTH PLAN",
            "identifier": "5952616",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCRE",
            "identifier": "AA2837",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID WELFARE",
            "identifier": "2097559",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.