Active NPI
Jeffrey Scott Burkett, M.D.
- Surgery Physician
- Neenah, WI
National Provider Identifier
1124078662
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 35305
- Practice address
- 100 Theda Clark Medical PLZ
Suite 400
Neenah, WI 54956-2763 - Phone
- (920) 725-4527
- Fax
- (920) 725-0991
- NPI assigned
- May 12, 2006
- Last updated
- Aug 1, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 35305 | WI | Primary |
| Surgery Physician | 208600000X | 74450 | AZ | |
| Trauma Surgery Physician | 2086S0127X | 35305 | WI | |
| Vascular Surgery Physician | 2086S0129X | 35305 | WI | |
| Colon & Rectal Surgery Physician | 208C00000X | 35305 | WI | |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 35305 | WI |
Addresses
Primary practice location
100 Theda Clark Medical PLZ
Suite 400
Neenah, WI 54956-2763
Mailing address
905 Windward CT
Neenah, WI 54956-4276
Phone (920) 729-4773
Other practice location 1
1757 E Baseline Rd Ste 131
Gilbert, AZ 85233-1534
Phone (480) 999-5248
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32014100 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Vascular Surgery
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1989
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1757 E Baseline Rd
Suite 131
Gilbert, AZ 85233-1534
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Spinal fusion | 1-10 |
| Colonoscopy | 29 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 17 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35305 | WI | MD | Colon & Rectal Surgery Physician |
Interoperability endpoints
- jburkett12780@direct.thedacare.org
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Neenah, WI
- NPI 1023472842
-
- General Acute Care Hospital
- Menasha, WI
- NPI 1720434806
-
- General Acute Care Hospital
- Neenah, WI
- NPI 1518993880
-
- General Acute Care Hospital
- Oshkosh, WI
- NPI 1861943409
-
- General Acute Care Hospital
- Oshkosh, WI
- NPI 1679937494
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754006400000",
"number": "1124078662",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "905 WINDWARD CT",
"city": "NEENAH",
"state": "WI",
"postal_code": "549564276",
"telephone_number": "920-729-4773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 THEDA CLARK MEDICAL PLZ",
"address_2": "SUITE 400",
"city": "NEENAH",
"state": "WI",
"postal_code": "549562763",
"telephone_number": "920-725-4527",
"fax_number": "920-725-0991"
}
],
"practiceLocations": [
{
"address_1": "1757 E Baseline Rd Ste 131",
"address_purpose": "LOCATION",
"city": "Gilbert",
"state": "AZ",
"postal_code": "852331534",
"country_code": "US",
"telephone_number": "480-999-5248",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BURKETT",
"first_name": "JEFFREY",
"middle_name": "SCOTT",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-12",
"last_updated": "2025-08-01",
"certification_date": "2025-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WI",
"license": "35305",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "AZ",
"license": "74450",
"primary": false
},
{
"code": "2086S0127X",
"taxonomy_group": "",
"desc": "Surgery, Trauma Surgery",
"state": "WI",
"license": "35305",
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "WI",
"license": "35305",
"primary": false
},
{
"code": "208C00000X",
"taxonomy_group": "",
"desc": "Colon & Rectal Surgery",
"state": "WI",
"license": "35305",
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "WI",
"license": "35305",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "32014100",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Neenah, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.