Active NPI
John William Burress, MD, MPH
- Family Medicine Physician
- Boston, MA
National Provider Identifier
1922127166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 75679
- Practice address
- 850 Harrison Ave
Yacc 4
Boston, MA 02118-4001 - Phone
- (617) 414-2080
- Fax
- (617) 414-2090
- NPI assigned
- Mar 28, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 75679 | MA | Primary |
Addresses
Primary practice location
850 Harrison Ave
Yacc 4
Boston, MA 02118-4001
Mailing address
720 Harrison Ave
Dob 503
Boston, MA 02118-2371
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110055304A | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- john.burress@4318.securemail.prognocis.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407369600000",
"number": "1922127166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 HARRISON AVE",
"address_2": "DOB 503",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 HARRISON AVE",
"address_2": "YACC 4",
"city": "BOSTON",
"state": "MA",
"postal_code": "021184001",
"telephone_number": "617-414-2080",
"fax_number": "617-414-2090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURRESS",
"first_name": "JOHN",
"middle_name": "WILLIAM",
"credential": "MD, MPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-28",
"last_updated": "2014-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MA",
"license": "75679",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110055304A",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.