Mary Simmons Burgess, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME131365 Issued in FL

Practice address

985 State Road 436
Casselberry, FL 32707-5664

Phone

(407) 831-5252

Fax

(407) 831-3765

NPI assigned

Mar 24, 2007

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 FL, NC2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.burgess.1@33201.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.

• Centerwell Senior Primary Care (NC) PC

  • Internal Medicine Physician
  • Gastonia, NC
  • NPI 1073034625

  Family Medicine

  Medicare reassignment NPD
• Centerwell Senior Primary Care (NC), P.C.

  • Internal Medicine Physician
  • Burlington, NC
  • NPI 1497575997

  Family Medicine

  NPD

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

{
    "created_epoch": "1174694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1861519787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985 STATE ROAD 436",
            "city": "CASSELBERRY",
            "state": "FL",
            "postal_code": "327075664",
            "telephone_number": "407-831-5252",
            "fax_number": "407-831-3765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "985 STATE ROAD 436",
            "city": "CASSELBERRY",
            "state": "FL",
            "postal_code": "327075664",
            "telephone_number": "407-831-5252",
            "fax_number": "407-831-3765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "MARY",
        "middle_name": "SIMMONS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-24",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME131365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beverly Y Brown
• Marqus Devonte Brown, D.C
• Shacara Brummitt, LMHC
• Isis Vidal Bucci, A.R.N.P.
• Katherine Anne Buntin, LCSW
• Faye Gabrielle Burkett, BCBA
• Shannon Burnick
• Max Burrell, PTA
• Adrian L Burrowes, MD
• Lucas Butler

• Family Medicine Physician in Casselberry, FL
• Providers in Casselberry, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.