Ricky R Burk, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

ATI2559 Issued in OR

Practice address

19801 SW 72ND Ave Ste 150
Tualatin, OR 97062-8347

Phone

(503) 691-2283

Fax

(503) 691-5981

NPI assigned

Jul 13, 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 14

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA, ID, OR, AK4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 4

Specialty

Optometry

Education

Indiana University - School of Optometry, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Cataract and Laser Institute Inc PCGroup PAC ID 7517864119, shared by 15 NPIs, 75 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Pacific Cataract and Laser Institute, Inc., P.C.

  • Ambulatory Surgical Clinic/Center
  • Tualatin, OR
  • NPI 1265609945
  Medicare reassignment NPD
• Pacific Cataract and Laser Institute Inc PC

  • Ambulatory Surgical Clinic/Center
  • Bellevue, WA
  • NPI 1306013925
  Medicare reassignment NPD
• Pacific Cataract and Laser Institute, Inc., P.C.

  • Ambulatory Surgical Clinic/Center
  • Chehalis, WA
  • NPI 1114978848

  ID

  Medicare reassignment NPD
• Pacific Cataract and Laser Institute of Alaska Inc PC

  • Ambulatory Surgical Clinic/Center
  • Anchorage, AK
  • NPI 1548213077
  Medicare reassignment
• Pacific Cataract and Laser Institute Inc PC

  • Ambulatory Surgical Clinic/Center
  • Boise, ID
  • NPI 1275700957
  NPD
• Pacific Cataract and Laser Institute Inc PC

  • Ambulatory Surgical Clinic/Center
  • Chehalis, WA
  • NPI 1487821633
  NPD
• Pacific Cataract and Laser Institute Inc PC

  • Ambulatory Surgical Clinic/Center
  • Vancouver, WA
  • NPI 1659548329
  NPD
• Pacific Cataract and Laser Institute, Inc., P.C.

  • Ophthalmologic Surgery Clinic/Center
  • Auburn, WA
  • NPI 1528814647
  NPD
• Pacific Cataract and Laser Institute, Inc., P.C.

  • Ambulatory Surgical Clinic/Center
  • Kennewick, WA
  • NPI 1619144607
  NPD
• Pacific Cataract and Laser Institute, Inc., P.C.

  • Ambulatory Surgical Clinic/Center
  • Spokane Valley, WA
  • NPI 1831366517
  NPD

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1245255686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1506",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985320409",
            "telephone_number": "360-242-3008",
            "fax_number": "360-807-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19801 SW 72ND AVE STE 150",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628347",
            "telephone_number": "503-691-2283",
            "fax_number": "503-691-5981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURK",
        "first_name": "RICKY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "ATI2559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245255686",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "410031430",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "410031420",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "410031421",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "410031424",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410031425",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "410031427",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "410045000",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "410031423",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2019370",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209408",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "410031428",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023231",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "410031429",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ricky.burk.p1@direct.pcli.nextgenshare.com",
            "affiliation": "N",
            "address_1": "19801 SW 72nd Ave Ste 150",
            "city": "Tualatin",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970628347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joan Marie Browning, M.D., M.S.P.H.
• Victoria Bryson, PT
• Rani Bui, PA
• Jacob Douglas Burgis, RPH
• Gary A Burgoine, MD
• Miranda Kaylin Busch
• John Alan Butler, M.D.
• Cynthia Page Buxton, N.D., LAC
• Wynter Byrnes, LA.C, LMT
• C. Edward Skeeters,M.D. & Michael P. Gardner,M.D.

• Optometrist in Tualatin, OR
• Providers in Tualatin, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; 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.