Individual provider Active NPI

Kelly Lynn Burkert, M.D.

  • Dermatology Physician
  • Media, PA
National Provider Identifier
1225012370
Registry record updated Jan 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME89124 Issued in FL
Practice address
101 Chesley Dr
Media, PA 19063-1761
Phone
(610) 566-7846
Fax
(610) 891-6735
NPI assigned
Dec 2, 2005
Last updated
Jan 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME89124 FL Primary

Addresses

Primary practice location

101 Chesley Dr
Media, PA 19063-1761

Mailing address

101 Chesley Dr
Media, PA 19063-1761
Phone (610) 566-7846

Other identifiers 1

IdentifierTypeStateIssuer
1225012370OtherPANPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20090629000058 PA Practitioner - Dermatology 0749250215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Jefferson Medical College of Thomas Jefferson University, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dermatology LTDGroup PAC ID 0244120756, 10 clinicians

Practice addresses (Care Compare)

101 Chesley Dr
Suite 100
Media, PA 19063-1761
Phone (610) 566-7111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.71 of 100Reported as group
Quality
70.4
Promoting interoperability
91
Improvement activities
40
Cost
79.48

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision42
Removal of skin lesions1057
Removal or shaving of skin growth272
Skin biopsy240

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology LTD Dermatology CurrentSince Jul 13, 2009 Accepting new patients

Locations

1788 Wilmington W Chester Pike
Ste 2200
Glen Mills, PA 19342
Phone (610) 566-7111

101 Chesley Dr
Media, PA 19063
Phone (484) 621-0082

101 Chesley Dr
Ste 100
Media, PA 19063
Phone (610) 565-2640

Organizations & group practices 1

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

Hospital & facility affiliations 2

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": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420761600000",
    "number": "1225012370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CHESLEY DR",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190631761",
            "telephone_number": "610-566-7846",
            "fax_number": "610-891-6735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CHESLEY DR",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190631761",
            "telephone_number": "610-566-7846",
            "fax_number": "610-891-6735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKERT",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-02",
        "last_updated": "2015-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME89124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1225012370",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.