Perel Ethel Bursky-Tammam, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

31882601 Issued in NY

Practice address

495 Beach 20TH St
Far Rockaway, NY 11691-3621

Phone

(347) 619-5950

NPI assigned

Mar 28, 2019

Sex

Female

Sole proprietor

No

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14448/brand/1/csg/1/fhir/r4
• Direct secure messaging: perel.bursky-tammam.1@14448.direct.athenahealth.com

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.

• St John'S Medical Services PC

  • Internal Medicine Physician
  • Far Rockaway, NY
  • NPI 1023042173
  Medicare reassignment NPD

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1821559121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 ELM ST",
            "city": "WEST HEMPSTEAD",
            "state": "NY",
            "postal_code": "115523224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 BEACH 20TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116913621",
            "telephone_number": "347-619-5950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURSKY-TAMMAM",
        "first_name": "PEREL",
        "middle_name": "ETHEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "31882601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Burgrave, LCSW R
• Christine B Burgwin
• Deron James-Suubi Burkhead, LMT
• Cymara H. Burns, R.N.
• Adena Burnstein, M.D.
• Boris Byalik, D.O.
• Christopher Byrne, M.S.
• Mary Byrnes, LCSW
• Mindy Cacciatore
• Julmercivety Cain, LPN

• Pediatrics Physician in Far Rockaway, NY
• Providers in Far Rockaway, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.