BURBANK EMERGENCY MEDICAL GROUP INC – Emergency Medicine Physician, NPI 1689636730
Emergency Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Loading map...
Provider Addresses for BURBANK EMERGENCY MEDICAL GROUP INC
501 S BUENA VISTA ST
BURBANK, CA 915054809
Phone: (818) 847-4055
Fax: (818) 848-4320
Type: Mailing
Providence Saint Joseph Medical Center, 501, South Buena Vista Street, Burbank, Los Angeles County, California, 91505, United States
EM DEPT
BURBANK, CA 915054809
Phone: (818) 843-5111
Type: Location
West Memorial Road, Oklahoma City, Oklahoma County, Oklahoma, 73142, United States
SUITE 121
OKLAHOMA CITY, OK 731341785
Phone: (800) 477-8909
Fax: (405) 751-3183
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
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: 2003-12-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-08-31 (1011 days ago).
Enrollment records
1
Earliest due date
2023-08-31
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 |
|---|---|---|---|---|
| O20031209001109 | O | Clinic/Group Practice | CA | 2023-08-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 91505)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.