Terecie-Ann Mavis Burgess, RPA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

014538 Issued in NY

Practice address

121 Dekalb Ave
Brooklyn, NY 11201-5425

Phone

(718) 250-6930

NPI assigned

Feb 15, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Modern Physician Services PCGroup PAC ID 6204140544, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359

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.

• Modern Physician Services PC

  • Urgent Care Clinic/Center
  • Brooklyn, NY
  • NPI 1932590601
  Medicare reassignment Care Compare group
• Kingsbrook Medical Associates, PC

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1104112838
  Medicare reassignment
• TBHC Medical Services PC

  • Family Medicine Physician
  • Brooklyn, NY
  • NPI 1508959743
  Medicare reassignment
• Kingsbrook Medical Associates PC

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1770844797
  NPD

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

{
    "created_epoch": "1297728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297728000000",
    "number": "1720385446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 E 92ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112121135",
            "telephone_number": "718-954-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 DEKALB AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015425",
            "telephone_number": "718-250-6930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "TERECIE-ANN",
        "middle_name": "MAVIS",
        "name_prefix": "Miss",
        "credential": "RPA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-15",
        "last_updated": "2011-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zoe Taylor Burger, LMSW
• John Michael Burgeson, PHARM.D.
• Jeanel Michelle Burgess-Belfon
• Annette Marcia Burgess, NP
• Blair Burgess, CASAC
• Traci Burgess, MD
• William Christian Burgess, LMSW
• Wala Burghol
• Gemma Burgio, L-CAT, ATR-BC, MPS
• Maria R Burgio, PH.D.

• Physician Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.