Active NPI
Ronald G Burke, MD
- Pediatric Orthopaedic Surgery Physician
- Fort Worth, TX
National Provider Identifier
1306858295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Orthopaedic Surgery Physician
- License
- H7591
- Practice address
- 1500 Cooper St
Fort Worth, TX 76104-2710 - Phone
- (682) 885-4405
- Fax
- (682) 885-4407
- NPI assigned
- Aug 12, 2006
- Last updated
- Apr 2, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | H7591 | TX | |
| Pediatric Orthopaedic Surgery Physician | 207XP3100X | H7591 | TX | Primary |
Addresses
Primary practice location
1500 Cooper St
Fort Worth, TX 76104-2710
Mailing address
PO Box 99371
Fort Worth, TX 76199-0371
Phone (682) 885-1855
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10008081 | Other | TX | AMERIGROUP PIN |
| 155848803 | Medicaid | TX | |
| 00U87Z | Other | TX | BCBSTX GRP PIN |
| 155848804 | Other | TX | CSHCN |
| 8G3391 | Other | TX | BCBSTX IND PIN |
| 1850793 | Other | TX | FIRSTHEALTH PIN |
| 133133100 | Other | TX | FIRSTCARE PIN |
| 140442852 | Medicaid | TX | |
| 124032 | Other | TX | SUPERIOR PIN |
| 4201830 | Other | TX | CIGNA PIN |
| 137345810 | Medicaid | TX | |
| 2278186 | Other | TX | UHC PIN |
| 7424364 | Other | TX | AETNA PIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H7591 | TX | MD | Pediatric Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cook Children's Physician Network | Current | Accepting new patients | |
| Cook Children's Physician Network | Current | Accepting new patients |
Locations
1500 Cooper St
Ft Worth, TX 76104
Phone (682) 885-2500
801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054
136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412
Interoperability endpoints
- rburke12697@cookchildrens.direct-ci.com
Organizations & group practices 2
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.
-
- Pediatrics Physician
- Fort Worth, TX
- NPI 1750369203
-
- Pediatrics Physician
- Fort Worth, TX
- NPI 1083472062
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333324800000",
"number": "1306858295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 99371",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761990371",
"telephone_number": "682-885-1855",
"fax_number": "682-885-4734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 COOPER ST",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761042710",
"telephone_number": "682-885-4405",
"fax_number": "682-885-4407"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURKE",
"first_name": "RONALD",
"middle_name": "G",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2012-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "TX",
"license": "H7591",
"primary": false
},
{
"code": "207XP3100X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
"state": "TX",
"license": "H7591",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP PIN",
"identifier": "10008081",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "155848803",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSTX GRP PIN",
"identifier": "00U87Z",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CSHCN",
"identifier": "155848804",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSTX IND PIN",
"identifier": "8G3391",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRSTHEALTH PIN",
"identifier": "1850793",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRSTCARE PIN",
"identifier": "133133100",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "140442852",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SUPERIOR PIN",
"identifier": "124032",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PIN",
"identifier": "4201830",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "137345810",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC PIN",
"identifier": "2278186",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PIN",
"identifier": "7424364",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.