Individual provider Active NPI

Jacob Mark Burdett, DO

  • Otolaryngology Physician
  • Tulsa, OK
National Provider Identifier
1104366574
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
7558 Issued in OK
Practice address
6475 S Yale Ave Ste 401
Tulsa, OK 74136-7818
Phone
(918) 502-9555
Fax
(918) 502-9559
NPI assigned
Mar 3, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 036160720 IL
Otolaryngology Physician 207Y00000X 7558 OK Primary

Addresses

Primary practice location

6475 S Yale Ave Ste 401
Tulsa, OK 74136-7818

Mailing address

6600 S Yale Ave Ste 1400
Tulsa, OK 74136-3331

Other practice location 1

1919 S Wheeling Ave Ste 500
Tulsa, OK 74104-5634
Phone (918) 403-6284

Other practice location 2

2601 W Main St
Carbondale, IL 62901-1031
Phone (618) 549-5361

Other practice location 3

4190 City Ave
Philadelphia, PA 19131-1626
Phone (215) 871-6690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, OK2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220715002503 IL Practitioner - Otolaryngology 1557742947 Reassigns benefits to 1 organization
I20220915002535 OK Practitioner - Otolaryngology 1557742947 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Arizona College of Osteopathic Medicine Mid Western University, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Warren Clinic IncGroup PAC ID 8820900293, 787 clinicians

Practice addresses (Care Compare)

6161 S Yale Ave
Tulsa, OK 74136-1902
Phone (918) 502-4720

6600 S Yale Ave
Suite 1400
Tulsa, OK 74136-3331
Phone (918) 488-6000

Hospital & facility affiliations

  • Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091
  • Saint Francis Hospital South, LLC Hospital, Tulsa, OK, CCN 370218
  • Saint Francis Hospital Muskogee Hospital, Muskogee, OK, CCN 370025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
7558OKMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Warren Clinic Inc CurrentSince Dec 4, 2023 Accepting new patients
St. John Physicians, Inc CurrentSince Sep 5, 2022 Accepting new patients
Southern Illinois Medical Services, NFP CurrentSince Jul 18, 2022 Accepting new patients
St. John Physicians, Inc. Current Accepting new patients
Saint Francis Hospital, Inc. Past Accepting new patients

Locations

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

6475 S Yale Ave
Ste 401
Tulsa, OK 74136
Phone (918) 502-9555

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

1919 S Wheeling Ave
Ste 500
Tulsa, OK 74104
Phone (918) 293-6200

10507 E 91st St
Ste 110
Tulsa, OK 74133
Phone (918) 307-3100

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

1725 E 19th St
Ste 500
Tulsa, OK 74104
Phone (918) 403-7089

Interoperability endpoints

  • Direct secure messaging: jburdett305329@direct.saintfrancis.com
  • Direct secure messaging: jburdett61167@sih.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1104366574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE STE 1400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6475 S YALE AVE STE 401",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367818",
            "telephone_number": "918-502-9555",
            "fax_number": "918-502-9559"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1919 S Wheeling Ave Ste 500",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741045634",
            "country_code": "US",
            "telephone_number": "918-403-6284",
            "fax_number": "918-403-6323",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2601 W Main St",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011031",
            "country_code": "US",
            "telephone_number": "618-549-5361",
            "fax_number": "618-351-4878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4190 City Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191311626",
            "country_code": "US",
            "telephone_number": "215-871-6690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURDETT",
        "first_name": "JACOB",
        "middle_name": "MARK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-03",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036160720",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OK",
            "license": "7558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.