Robert W. Burk III, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME57422 Issued in FL

Practice address

209 Ponte Vedra Park Dr
Ponte Vedra Beach, FL 32082-6600

Phone

(904) 273-6200

Fax

(904) 280-8013

NPI assigned

Aug 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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 1

Specialty

Plastic and Reconstructive Surgery

Education

Duke University School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ponte Vedra Plastic Surgery, Inc.Group PAC ID 5890786701, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Ponte Vedra Plastic Surgery, Inc

  • Specialist
  • Ponte Vedra Beach, FL
  • NPI 1841461100
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430438400000",
    "number": "1174630644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 PONTE VEDRA PARK DR",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320826600",
            "telephone_number": "904-273-6200",
            "fax_number": "904-280-8013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 PONTE VEDRA PARK DR",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320826600",
            "telephone_number": "904-273-6200",
            "fax_number": "904-280-8013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURK",
        "first_name": "ROBERT",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2015-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME57422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377927100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara Brutschy
• Bubbles ABA, LLC
• Julie A Buckley, M.D., F.A.A.P.
• Gerard Joseph Budd, M.D.
• Eric S Burgess, D.M.D.,F.A.C.D.
• Alexis Buster, RBT
• Daniel M Calloway, MD
• Katie Longo Cantrell, MD
• Mark A Cappel, MD
• Victor M Cardenas, M.D.

• Specialist in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2015; 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.

Verify at the official NPI Registry.