P. Roman Burk, D.P.M.
Individual provider Active NPI Foot & Ankle Surgery Podiatrist · Caldwell, ID
NPI 1306064258 · NPPES record last updated Dec 13, 2013
Key facts
- NPI
- 1306064258
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Foot & Ankle Surgery Podiatrist 213ES0103X
- License
- P-197 (ID)
- Practice address
- 1818 S 10TH Ave
Suite 250
Caldwell, ID 83605-4803 - Phone
- (208) 459-0891
- Fax
- (208) 459-8628
- NPI assigned
- Apr 23, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Podiatry
- Education
- Temple University School of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- P. Roman Burk DPM PC
Practice addresses (Care Compare)
2667 E Gala CT
Suite 130
Meridian, ID 83642-2788
Phone (208) 795-5090
Hospital & facility affiliations
- Saint Alphonsus Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.91 of 100
- Quality
- 91.1
- Promoting interoperability
- 96
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 29 |
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 295 |
| Removal or shaving of skin growth | 19 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080429000168 | ID | Practitioner - Podiatry | 1254419492 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41000197 | IN | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| P. Roman Burk DPM PC | Podiatrist | Current |
Accepting new patients |
| Core Medicine Idaho, LLC | Current |
Accepting new patients | |
| P. Roman Burk DPM PC | Past | Accepting new patients | |
| P. Roman Burk DPM, PC | Past | Accepting new patients | |
| Foot & Ankle Medical Center of Nampa, P.a. | Podiatrist | Past |
Accepting new patients |
| P. Roman Burk DPM PC | Past | Accepting new patients |
Locations
4605 Enterprise Way
Ste 103
Caldwell, ID 83605
Phone (208) 855-5955
1818 S 10th Ave
Ste 250
Caldwell, ID 83605
Phone (208) 459-0891
2667 E Gala Ct
Ste 130
Meridian, ID 83642
Phone (208) 459-0891
1828 S Millenium Way
Ste 200
Meridian, ID 83642
Phone (208) 344-3324
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/AEHGCD/Endpoint/AEHGCD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 41000197 | IN | |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | P-197 | ID | Yes |
Addresses
Primary practice location
1818 S 10TH Ave
Suite 250
Caldwell, ID 83605-4803
Mailing address
1818 S 10TH Ave
Suite 250
Caldwell, ID 83605-4803
Phone (208) 459-0891
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010167550 | Other | ID | REGENCE BLUE SHIELD |
| P2447 | Other | ID | BLUE CROSS |
| 8080019 | Medicaid | ID | |
| 6701670001 | Other | ID | MEDICARE DME PTAN |
Other providers in Caldwell, ID
- Sherri L Brown
- Gavin Bruderer
- Angela Bruno
- Cadence Brunzlick
- Eric Ray Burfeind
- Isaac K Burton
- Anthony Frederick Bushnell
- Lance Joseph Buxton
- Tara Byrne
- Caldwell Counseling Associates, PLLC
All providers in Caldwell, ID · Foot & Ankle Surgery Podiatrist in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 13, 2013. 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.
- Order and Referring (CMS).
- 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.