Individual provider Active NPI

Andrew Burchak, MD

  • General Practice Physician
  • Yuma, AZ
National Provider Identifier
1811456049
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
0101270811 Issued in VA
Practice address
Marine Corps. Air Station Yuma
Yuma, AZ 85365
Phone
(928) 269-5276
NPI assigned
Mar 18, 2019
Last updated
Feb 24, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 0101270811 VA Primary
Military Health Care Provider 171000000X

Addresses

Primary practice location

Marine Corps. Air Station Yuma
Yuma, AZ 85365

Mailing address

Naval Medical Center San Diego 38400 Bob Wilson Dr
San Diego, CA 92134-5000
Phone (208) 451-4309

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101270811VAMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1811456049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL MEDICAL CENTER SAN DIEGO 38400 BOB WILSON DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921345000",
            "telephone_number": "208-451-4309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MARINE CORPS. AIR STATION YUMA",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "85365",
            "telephone_number": "928-269-5276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURCHAK",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101270811",
            "primary": true
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

Verify at the official NPI Registry.