Active NPI
Welland Dane Burnside, MD GRADUATE MAY 2019
- Internal Medicine Physician
- Plattsburgh, NY
National Provider Identifier
1912460858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 317488
- Practice address
- 75 Beekman St
Plattsburgh, NY 12901-1438 - Phone
- (518) 561-2000
- NPI assigned
- Apr 8, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 317488 | NY | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
75 Beekman St
Plattsburgh, NY 12901-1438
Mailing address
75 Beekman St
Plattsburgh, NY 12901-1438
Phone (518) 516-2000
Other practice location 1
40 Medical Park
Wheeling, WV 26003-6392
Phone (304) 243-3880
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
75 Beekman St
Plattsburgh, NY 12901-1438
Phone (518) 561-2000
Hospital & facility affiliations
- The University of Vermont Health Network - Champl
- Elizabethtown Community Hospital
- The University of Vermont Health Network-Alice Hy
- Univ. of Vermont - Fletcher Allen Health Care
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Champlain Valley Physicians Hospital Medical Center | Internal Medicine | Current | Accepting new patients |
| Champlain Valley Physicians Hospital Medical Center | Past | Accepting new patients |
Locations
75 Beekman St
Plattsburgh, NY 12901
Phone (518) 562-7100
Interoperability endpoints
- wburnside500731@direct.uvmhealth.org
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Plattsburgh, NY
- NPI 1124189782
-
- General Acute Care Hospital
- Plattsburgh, NY
- NPI 1033270699
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Malone, NY
- NPI 1114954682
-
- General Acute Care Hospital
- Plattsburgh, NY
- NPI 1033270699
-
- Critical Access Hospital
- Elizabethtown, NY
- NPI 1891785184
-
- General Acute Care Hospital
- Burlington, VT
- NPI 1568419976
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1912460858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 BEEKMAN ST",
"city": "PLATTSBURGH",
"state": "NY",
"postal_code": "129011438",
"telephone_number": "518-516-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 BEEKMAN ST",
"city": "PLATTSBURGH",
"state": "NY",
"postal_code": "129011438",
"telephone_number": "518-561-2000"
}
],
"practiceLocations": [
{
"address_1": "40 Medical Park",
"address_purpose": "LOCATION",
"city": "Wheeling",
"state": "WV",
"postal_code": "260036392",
"country_code": "US",
"telephone_number": "304-243-3880",
"fax_number": "304-243-3895",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BURNSIDE",
"first_name": "WELLAND",
"middle_name": "DANE",
"name_prefix": "Dr.",
"credential": "MD GRADUATE MAY 2019",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-08",
"last_updated": "2022-07-21",
"certification_date": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "317488",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plattsburgh, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.