Individual provider Active NPI

Michael Louis Burleson, M.D.

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1841265618
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME 102060 Issued in FL
Practice address
14529 Marsh View Dr
Jacksonville, FL 32250-2058
Phone
(305) 304-5727
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G75674 CA
Family Medicine Physician 207Q00000X ME 102060 FL Primary

Addresses

Primary practice location

14529 Marsh View Dr
Jacksonville, FL 32250-2058

Mailing address

14529 Marsh View Dr
Jacksonville, FL 32250-2058
Phone (305) 304-5727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20110225000624 FL Practitioner - Family PracticePractitioner - Emergency Medicine 0547441362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G75674CAMDFamily Medicine Physician
ME 102060FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Inc CurrentSince Dec 17, 2012 Accepting new patients
Emergency Physicians Inc CurrentSince Dec 17, 2012 Accepting new patients
Augustine Emergency Physicians LLC Past Accepting new patients

Locations

1250 S 18th St
Ste 202
Fernandina Beach, FL 32034
Phone (904) 202-2000

1747 Baptist Clay Dr
Ste 250
Fleming Isle, FL 32003
Phone (904) 516-1000

400 Health Park Blvd
St Augustine, FL 32086
Phone (904) 819-4300

Interoperability endpoints

  • Direct secure messaging: mburleson743021@direct.shands.ufl.edu

Organizations & group practices 3

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1841265618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14529 MARSH VIEW DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322502058",
            "telephone_number": "305-304-5727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14529 MARSH VIEW DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322502058",
            "telephone_number": "305-304-5727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURLESON",
        "first_name": "MICHAEL",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G75674",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 102060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.