Active NPI
Phyllis Jean Burson, PHD
- Psychologist
- Bethesda, MD
National Provider Identifier
1972713626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1075
- Practice address
- 7501 Elmore Lane
Bethesda, MD 20817 - Phone
- (301) 229-9224
- NPI assigned
- May 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1075 | MD | Primary |
Addresses
Primary practice location
7501 Elmore Lane
Bethesda, MD 20817
Mailing address
7501 Elmore Lane
Bethesda, MD 20817
Phone (301) 229-9224
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 216241500 | Medicaid | MD | |
| A910MEMBER0001 | Other | CARE FIRST BCBS NCA |
Other names 1
- Phyllis Jean Biesemeier
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040922000580 | DC | Practitioner - Clinical Psychologist | 3971571449 | Practice locations: Bethesda, MD |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1974
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
7501 Elmore Lane
Bethesda, MD 20817-5503
Phone (301) 229-9224
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1075 | MD | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345507200000",
"number": "1972713626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7501 ELMORE LANE",
"city": "BETHESDA",
"state": "MD",
"postal_code": "20817",
"telephone_number": "301-229-9224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7501 ELMORE LANE",
"city": "BETHESDA",
"state": "MD",
"postal_code": "20817",
"telephone_number": "301-229-9224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURSON",
"first_name": "PHYLLIS",
"middle_name": "JEAN",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-23",
"last_updated": "2012-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MD",
"license": "1075",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "216241500",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE FIRST BCBS NCA",
"identifier": "A910MEMBER0001",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "PHYLLIS",
"last_name": "BIESEMEIER",
"middle_name": "JEAN",
"credential": "PHD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bethesda, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2012; 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.