Active NPI
Ricky T Burrescia, P.A.-C
- Physician Assistant
- Lubbock, TX
National Provider Identifier
1710906490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA00664
- Practice address
- 4002 21St St
Suite a
Lubbock, TX 79410-1135 - Phone
- (806) 793-1406
- Fax
- (806) 796-1167
- NPI assigned
- Jul 19, 2006
- Last updated
- Aug 20, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA00664 | TX | Primary |
Addresses
Primary practice location
4002 21St St
Suite a
Lubbock, TX 79410-1135
Mailing address
4002 21St St
Suite a
Lubbock, TX 79410-1135
Phone (806) 793-1406
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1008402 | Other | TX | NCCPA CERTIFICATION |
| PA00664 | Other | TX | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ming Global, LC | Past | Accepting new patients | |
| Radiation Oncology of the South Plains, P.a. | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Radiation Oncology Physician
- Lubbock, TX
- NPI 1992896633
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250726400000",
"number": "1710906490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4002 21ST ST",
"address_2": "SUITE A",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794101135",
"telephone_number": "806-793-1406",
"fax_number": "806-796-1167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4002 21ST ST",
"address_2": "SUITE A",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794101135",
"telephone_number": "806-793-1406",
"fax_number": "806-796-1167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURRESCIA",
"first_name": "RICKY",
"middle_name": "T",
"name_prefix": "Mr.",
"credential": "P.A.-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2009-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA00664",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCCPA CERTIFICATION",
"identifier": "1008402",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "PA00664",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.