Organization Active NPI

Burke Dermatology SC

  • Dermatology Physician
  • Evergreen, CO
National Provider Identifier
1295976256
Registry record updated May 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
036122682 Issued in IL
Legal business name
BURKE DERMATOLOGY SC
Practice address
2942 Evergreen Pkwy Ste 100
Evergreen, CO 80439-7909
Phone
(720) 836-9981
Fax
(720) 386-9132
NPI assigned
Mar 20, 2009
Last updated
May 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2025

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

Authorized official

Name
Dr. William Sean Burke, MDNPI 1760604276
Title
President
Phone
(720) 836-9981

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 036122682 IL Primary

Addresses

Primary practice location

2942 Evergreen Pkwy Ste 100
Evergreen, CO 80439-7909

Mailing address

2942 Evergreen Pkwy Ste 100
Evergreen, CO 80439-7909
Phone (720) 836-9981

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220502002460 CO Part B Supplier - Clinic/Group Practice 9537213954 Receives reassigned benefits from 1 practitioner
Practice locations: Evergreen, CO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2263780Burke Dermatology2942 Evergreen Parkway, Suite 100, Evergreen, CO 80439Certificate of waiverJul 4, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1237507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748217600000",
    "number": "1295976256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2942 EVERGREEN PKWY STE 100",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804397909",
            "telephone_number": "720-836-9981",
            "fax_number": "720-386-9132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2942 EVERGREEN PKWY STE 100",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804397909",
            "telephone_number": "720-836-9981",
            "fax_number": "720-386-9132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURKE DERMATOLOGY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-20",
        "last_updated": "2025-05-26",
        "certification_date": "2025-05-17",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "SEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "720-836-9981",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036122682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.