NPIMap

Individual provider Active NPI

Brian Leslie Burnette, MD

  • Hematology & Oncology Physician
  • Green Bay, WI
National Provider Identifier
1952523680
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
60800 Issued in WI
Practice address
835 S Van Buren St
Green Bay, WI 54301-3526
Phone
(920) 432-6049
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 49937 MN
Hematology & Oncology Physician 207RH0003X 60800 WI Primary

Addresses

Primary practice location

835 S Van Buren St
Green Bay, WI 54301-3526

Mailing address

835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 432-6049

Other identifiers 2

IdentifierTypeStateIssuer
050198000MedicaidMN
P00428374OtherMNMEDICARE RAILROAD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bburnette40261@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130705000043 WI Practitioner - Hematology/Oncology 2567557184 Reassigns benefits to 2 organizations
I20140120000548 MI Practitioner - Hematology/Oncology 2567557184 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Michigan State University College of Human Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascension NE Wisconsin, IncGroup PAC ID 7719897784, 19 clinicians
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

1506 S Oneida St
Appleton, WI 54915-1305
Phone (920) 738-2000

2525 5TH Ave S
Escanaba, MI 49829-1204
Phone (906) 786-6047

835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 433-0111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49937MNMDInternal Medicine Physician
60800WIMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Francis Hospital Current Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Internal Medicine CurrentSince Jun 1, 2015 Accepting new patients
Schoolcraft Memorial Hospital CurrentSince Oct 1, 2017 Accepting new patients
Ascension NE Wisconsin, Inc CurrentSince Jan 15, 2016 Accepting new patients
St Francis Hospital CurrentSince Jun 30, 2015 Accepting new patients
Osf Multi-Specialty Group Internal Medicine CurrentSince May 20, 2024 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Jun 1, 2015 Accepting new patients
Ascension NE Wisconsin, Inc CurrentSince Jan 15, 2016 Accepting new patients
St. Francis Hospital Internal Medicine CurrentSince Jun 30, 2015 Accepting new patients
St Francis Hospital Past Accepting new patients

Locations

2525 5th Ave S
Escanaba, MI 49829
Phone (906) 233-4276

3409 Ludington St
Ste 104
Escanaba, MI 49829
Phone (906) 786-8343

3401 Ludington St
Escanaba, MI 49829
Phone (906) 786-3311

126 S 25th St
#B
Escanaba, MI 49829
Phone (906) 233-9500

7870W US Highway 2
Manistique, MI 49854
Phone (906) 341-2153

1506 S Oneida St
Appleton, WI 54915
Phone (920) 730-4950

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

2300 Western Ave
Manitowoc, WI 54220
Phone (920) 320-2011

Organizations & group practices 10

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1952523680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 S VAN BUREN ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013526",
            "telephone_number": "920-432-6049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 S VAN BUREN ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013526",
            "telephone_number": "920-432-6049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETTE",
        "first_name": "BRIAN",
        "middle_name": "LESLIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "49937",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "WI",
            "license": "60800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "050198000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00428374",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bburnette40261@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "835 S Van Buren St",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543013526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.