Individual provider Active NPI

Michelle Ann Burgard, D.O.

  • Internal Medicine Physician
  • Warren, MI
National Provider Identifier
1386093649
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101022623 Issued in MI
Practice address
11885 E 12 Mile Rd Ste 300a
Warren, MI 48093-3467
Phone
(586) 582-6630
Fax
(586) 582-6631
NPI assigned
Jun 8, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101022623 MI Primary

Addresses

Primary practice location

11885 E 12 Mile Rd Ste 300a
Warren, MI 48093-3467

Mailing address

11885 E 12 Mile Rd Ste 300a
Warren, MI 48093-3467
Phone (586) 582-6630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190911003258 IA Practitioner - Internal Medicine 6204126717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2515 SW State St
Suite 100
Ankeny, IA 50023-7079
Phone (515) 964-6929

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101022623MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Physicians Clinic Medical Foundation Internal Medicine CurrentSince Sep 3, 2019 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients

Locations

2515 SW State St
Ste 100
Ankeny, IA 50023
Phone (515) 964-6929

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

1776 Westlakes Pkwy
Ste 400
West Des Moines, IA 50266
Phone (515) 241-6161

Interoperability endpoints

  • Direct secure messaging: mburgard692144@direct.unitypoint.org

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 and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1386093649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11885 E 12 MILE RD STE 300A",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933467",
            "telephone_number": "586-582-6630",
            "fax_number": "586-582-6631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11885 E 12 MILE RD STE 300A",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933467",
            "telephone_number": "586-582-6630",
            "fax_number": "586-582-6631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGARD",
        "first_name": "MICHELLE",
        "middle_name": "ANN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-08",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101022623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.