Active NPI
Harry D Burack, MD
- Gastroenterology Physician
- Saint Peters, MO
National Provider Identifier
1801909684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- R9806
- Practice address
- 5600 Mexico Rd
Suite 21
Saint Peters, MO 63376-1660 - Phone
- (636) 928-3858
- Fax
- (636) 928-0592
- NPI assigned
- Aug 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | R9806 | MO | Primary |
Addresses
Primary practice location
5600 Mexico Rd
Suite 21
Saint Peters, MO 63376-1660
Mailing address
5600 Mexico Rd
Suite 21
Saint Peters, MO 63376-1660
Phone (636) 928-3858
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
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physician Groups LC | Gastroenterology | Past | Accepting new patients |
Organizations & group practices 1
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": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323734400000",
"number": "1801909684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5600 MEXICO RD",
"address_2": "SUITE 21",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "633761660",
"telephone_number": "636-928-3858",
"fax_number": "636-928-0592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5600 MEXICO RD",
"address_2": "SUITE 21",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "633761660",
"telephone_number": "636-928-3858",
"fax_number": "636-928-0592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURACK",
"first_name": "HARRY",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-16",
"last_updated": "2011-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "MO",
"license": "R9806",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Peters, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.