Individual provider Active NPI

Heather Herson Burris, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1699839795
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
MD426760 Issued in PA
Practice address
3400 Spruce Street
8 Ravdin
Philadelphia, PA 19104
Phone
(215) 662-3228
Fax
(617) 667-7040
NPI assigned
Dec 21, 2006
Sex
Female
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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 230565 MA
Neonatal-Perinatal Medicine Physician 2080N0001X 230565 MA
Neonatal-Perinatal Medicine Physician 2080N0001X MD426760 PA Primary

Addresses

Primary practice location

3400 Spruce Street
8 Ravdin
Philadelphia, PA 19104

Mailing address

3400 Spruce Street
8 Ravdin
Philadelphia, PA 19104
Phone (215) 662-3228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20170825000575 PA Practitioner - Pediatric Medicine 2567503741 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD426760PAMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childen'S Health Care Associates Inc. CurrentSince Jul 1, 2017 Accepting new patients
Childrens Health Care Associates, Inc Pediatrics Current Accepting new patients
University of Penn-Medical Group CurrentSince Sep 1, 2017 Accepting new patients
Childrens Health Care Associates, Inc Neonatal-Perinatal Medicine CurrentSince Jul 1, 2017 Accepting new patients
University of Penn-Medical Group CurrentSince Sep 1, 2017 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Childrens Hospital of Philadelphia Past Accepting new patients

Locations

3400 Spruce St
Fl 8
Philadelphia, PA 19104
Phone (215) 662-2415

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

Organizations & group practices 7

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": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1699839795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "address_2": "8 RAVDIN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-3228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "address_2": "8 RAVDIN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-3228",
            "fax_number": "617-667-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRIS",
        "first_name": "HEATHER",
        "middle_name": "HERSON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "230565",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MA",
            "license": "230565",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "PA",
            "license": "MD426760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.