Timothy Robert Burke, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

G069226 Issued in CA

Practice address

12401 Wilshire Blvd
Suite 304
Los Angeles, CA 90025-1085

Phone

(310) 207-8775

Fax

(310) 207-8126

NPI assigned

May 11, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 17, 2017 through Jul 17, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1407061542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12401 WILSHIRE BLVD",
            "address_2": "SUITE 304",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251085",
            "telephone_number": "310-207-8775",
            "fax_number": "310-207-8126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12401 WILSHIRE BLVD",
            "address_2": "SUITE 304",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251085",
            "telephone_number": "310-207-8775",
            "fax_number": "310-207-8126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "TIMOTHY",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G069226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayren Burke, LMFT
• Makiya Burke
• Meredith Burke, MA, CCC- SLP
• Natalie Burke
• Sean William Burke, MA, AMFT, APCC
• Aaron David Burkenroad, MD
• Julia Debra Burkes, MSW
• Leslie Burkes, LMFT
• Brandon Burkhardt, LCSW
• Gary D. Burkhart, MD

• Psychiatry Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.