Burke Dermatology SC – Dermatology Physician

Key facts

NPI: 1295976256
Entity type: Organization (NPI type 2)
Primary specialty: Dermatology Physician 207N00000X
License: 036122682 (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
Organization subpart: No

Authorized official

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

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

William Sean Burke, MD Dermatology Physician · Evergreen, CO · NPI 1760604276

Medicare reassignment Authorized official CO

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
06D2263780	Burke Dermatology 2942 Evergreen Parkway, Suite 100, Evergreen, CO 80439	Certificate of waiver	Jul 4, 2028

Medicare participation

Medicare fee-for-service enrollment: Enrolled in CO

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20220502002460	CO	Part B Supplier - Clinic/Group Practice	9537213954	Receives reassigned benefits from 1 practitioner Practice locations: Evergreen, CO

National Provider Directory

Locations

2942 Evergreen Pkwy
Ste 100
Evergreen, CO 80439
Phone (303) 670-4802

600 N Giant City Rd
Carbondale, IL 62902
Phone (618) 300-6017

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Dermatology Physician Group: 193400000X SINGLE SPECIALTY GROUP	207N00000X	036122682	IL	Yes

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

Other identifiers

Identifier	Type	State	Issuer
3932097	Other	IL	BLUE CROSS/BLUE SHIELD OF ILLINOIS

Other providers in Evergreen, CO

All providers in Evergreen, CO · Dermatology Physician in Colorado

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 26, 2025. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (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.