CONNOR BURNSIDE (DO) – Geriatric Psychiatry Physician, NPI 1922595990
Geriatric Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,953 PSYCHIATRY in FL
Provider Addresses for CONNOR BURNSIDE (DO)
4037 NW 86TH TER # 3154
GAINESVILLE, FL 326069277
Phone: (352) 294-4945
Fax: (352) 594-1818
Type: Mailing
2080 MEADOWLAND PARK BLVD
LAKELAND, FL 338034326
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-09-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20241216001705 | I | Psychiatry | MI | TBD |
| I20250922001252 | I | Psychiatry | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32606)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | FL | |
| P S Y C H I A T R Y | NY | |
| Nurse Practitioner | KY | |
| P S Y C H I A T R Y | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| P S Y C H I A T R Y | NJ | |
| P S Y C H I A T R Y | FL | |
| P S Y C H I A T R Y | FL | |
| Nurse Practitioner | FL |
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