DR. RIESA M. BURNETT MD NPI 1396903589

NPI Information

NPI: 1396903589
Provider Name: DR. RIESA M. BURNETT, MD
Classification: Surgery - 2086S0122X
Entity Type: Individual

Specialization: Plastic and Reconstructive Surgery

Organization: ST VINCENT MEDICAL GROUP INC

PECOS Registration: Yes

Address:
13450 N MERIDIAN ST STE 244
CARMEL, IN
ZIP 46032
Phone: (317) 338-4303
Get Directions

DR. Riesa M. Burnett, MD is a plastic and reconstructive surgery surgery in Carmel, IN with 17 years of experience. The provider is a surgeon who specializes in plastic and reconstructive surgery. DR. Riesa M. Burnett, MD NPI is 1396903589. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: INDIANA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2007

The provider's business location address is:

13450 N MERIDIAN ST STE 244
CARMEL, IN
ZIP 46032-105
Phone: (317) 338-4303

The NPI 1396903589 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/25/2008 and was last updated on 7/3/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208600000X	Surgery		01067554A	INDIANA	No
2	2086S0122X	Surgery	Plastic and Reconstructive Surgery	35.126101	OHIO	No
3	2086S0122X	Surgery	Plastic and Reconstructive Surgery	01067554A	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	11014009A	OTHER	INDIANA	TEMPORARY STATE LICENCE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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