Individual provider Active NPI

Sean Devon Burnett, PA

  • Physician Assistant
  • Jamaica, NY
National Provider Identifier
1891893558
Registry record updated Sep 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
007356 Issued in NY
Practice address
8900 Van Wyck Expy
Emergency Department
Jamaica, NY 11418-2897
Phone
(718) 206-6070
Fax
(718) 206-6085
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 007356 NY Primary

Addresses

Primary practice location

8900 Van Wyck Expy
Emergency Department
Jamaica, NY 11418-2897

Mailing address

8900 Van Wyck Expy
Emergency Department
Jamaica, NY 11418-2897
Phone (718) 206-6070

Other identifiers 1

IdentifierTypeStateIssuer
00246075MedicaidNY

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080118000470 NY Practitioner - Physician Assistant 9537240288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Century Medical and Dental Center IncGroup PAC ID 8729070669, 107 clinicians

Practice addresses (Care Compare)

180 Myrtle Ave
Brooklyn, NY 11201-7059
Phone (718) 650-2233

260 Ave X
Brooklyn, NY 11223-5940
Phone (718) 336-8855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
007356NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
South Beach Medical PC Past Accepting new patients
Suny Downstate Medical Center Past Accepting new patients

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190592000000",
    "number": "1891893558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8900 VAN WYCK EXPY",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114182897",
            "telephone_number": "718-206-6070",
            "fax_number": "631-454-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 VAN WYCK EXPY",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114182897",
            "telephone_number": "718-206-6070",
            "fax_number": "718-206-6085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETT",
        "first_name": "SEAN",
        "middle_name": "DEVON",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "007356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00246075",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.