MARY LOUISE BURBANK RD
NPI 1922647601
Dietitian, Registered in Middletown, CT
About Mary Louise Burbank Rd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY LOUISE BURBANK RD (NPI 1922647601) is an individual dietitian, registered in Middletown, Connecticut, licensed in Connecticut (001431) and active in the NPI registry since December 2019.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mary Louise Burbank Rd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Mary Burbank reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Middletown, CT 06457
- Reassigned Medicare billing, Connecticut enrollment
- 147 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 8
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MIDDLETOWN, CT 06457
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mary Burbank's NPI number?
The NPI number for Mary Burbank is 1922647601. It was assigned to this individual provider in the NPPES registry on December 30, 2019. The provider is also known as Mary Louise Gates Rd.
Where is Mary Burbank located?
Mary Burbank practices at 540 Saybrook Rd Ste 100, Middletown, CT 06457. The listed phone number is (860) 287-1078.
What is Mary Burbank's specialty?
The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.
Is Mary Burbank enrolled in Medicare?
Yes. Mary Burbank is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Mary Burbank's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mary Burbank reassigns Medicare benefits to Mhs Primary Care Inc. (Middletown, CT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mary Burbank's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Mary Burbank was last updated on December 30, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mary Louise Burbank, RD · NPI 1922647601
Dietitian, Registered provider in Middletown, Connecticut. Individual provider, active in the CMS NPPES registry since December 30, 2019.
## Identity
- **NPI:** 1922647601 (Entity type: Individual)
- **Enumerated:** December 30, 2019
- **Primary specialty:** Dietitian, Registered · taxonomy 133V00000X
- **State license:** 001431 (Connecticut)
- **Sole proprietor:** No
## Practice location
- **Address:** 540 SAYBROOK RD STE 100, Middletown, CT 06457-4760
- **Phone:** (860) 287-1078
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** Mhs Primary Care Inc. (NPI 1740666312, Middletown, CT), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 30, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1922647601) · Data from the CMS NPPES public registry.