NPIMap

Individual provider Active NPI

Robert J Burnett, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Coeur D Alene, ID
National Provider Identifier
1104824150
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
M-8773 Issued in ID
Practice address
2003 Kootenai Health Way
Ste 300
Coeur D Alene, ID 83814-6051
Phone
(208) 666-2552
Fax
(208) 666-2556
NPI assigned
Jul 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD00036338 WA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X M-8773 ID Primary

Addresses

Primary practice location

2003 Kootenai Health Way
Ste 300
Coeur D Alene, ID 83814-6051

Mailing address

122 W 7TH Ave
Ste 110
Spokane, WA 99204-2349
Phone (509) 456-0262

Other identifiers 5

IdentifierTypeStateIssuer
G8878163OtherWAMEDICARE PTAN
8357345MedicaidWA
G8870910OtherWAMEDICARE PTAN
806593702MedicaidID
11104691OtherIDMEDICARE PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address robert.burnettmd.p79@direct.kootenai.nextgenshare.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031120000905 ID Practitioner - Cardiac SurgeryPractitioner - Thoracic SurgeryPractitioner - Vascular Surgery 1759285877 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac SurgeryAlso: Thoracic Surgery, Vascular Surgery
Education
University of Cincinnati College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kootenai Health IncGroup PAC ID 1355792276, 394 clinicians

Practice addresses (Care Compare)

1055 Riverside Ave
Orofino, ID 83544-9029
Phone (208) 476-5777

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051

Hospital & facility affiliations

  • Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049
  • St Mary'S Hospital Hospital, Cottonwood, ID, CCN 131321
  • St Joseph Regional Medical Center Hospital, Lewiston, ID, CCN 130003

Merit-based Incentive Payment System (MIPS)

Final score
86.65 of 100Reported as apm
Quality
89.26
Promoting interoperability
69.9
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)45

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kootenai Health, Inc. Current Accepting new patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Incyte Pathology, PLLC Current Accepting new patients
Kootenai Health, Inc. CurrentSince Apr 22, 2019 Accepting new patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Kadlec Regional Medical Center Past Accepting new patients
Peacehealth Medical Group Past Accepting new patients

Locations

2003 Kootenai Health Way
Ste 300
Coeur D Alene, ID 83814
Phone (208) 625-4120

2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085

1300 E Mullan Ave
Ste 700
Post Falls, ID 83854
Phone (208) 625-5564

1119 Highland Ave
Ste 4
Clarkston, WA 99403
Phone (509) 254-0080

101 W 8th Ave
Spokane, WA 99204
Phone (509) 474-3181

Interoperability endpoints

  • Direct secure messaging: rburnett350748@direct.multicare.org

Organizations & group practices 8

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 9

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": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1104824150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 W 7TH AVE",
            "address_2": "STE 110",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042349",
            "telephone_number": "509-456-0262",
            "fax_number": "509-462-5059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 KOOTENAI HEALTH WAY",
            "address_2": "STE 300",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838146051",
            "telephone_number": "208-666-2552",
            "fax_number": "208-666-2556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETT",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "WA",
            "license": "MD00036338",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "ID",
            "license": "M-8773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "G8878163",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8357345",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "G8870910",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806593702",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "11104691",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "robert.burnettmd.p79@direct.kootenai.nextgenshare.com",
            "affiliation": "N",
            "address_1": "2003 Kootenai Health Way",
            "address_2": "STE 300",
            "city": "Coeur D Alene",
            "state": "ID",
            "country_code": "US",
            "postal_code": "838146051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

Verify at the official NPI Registry.