Individual provider Active NPI

Paul Burke, M.D.

  • Neurology Physician
  • Reston, VA
National Provider Identifier
1437232675
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
200401476 Issued in NC
Practice address
1768 Business Center Dr Ste 100
Reston, VA 20190-5359
Phone
(800) 762-9244
Fax
(786) 672-6006
NPI assigned
Oct 23, 2006
Last updated
May 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 42328 KY
Neurology Physician 2084N0400X 200401476 NC Primary

Addresses

Primary practice location

1768 Business Center Dr Ste 100
Reston, VA 20190-5359

Mailing address

1768 Business Center Dr Ste 100
Reston, VA 20190-5359
Phone (800) 762-9244

Other identifiers 1

IdentifierTypeStateIssuer
5901242MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20050804000630 NC Practitioner - Neurology 1355370909 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TP270KYMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Access Telecare, PLLC Neurology CurrentSince Jan 14, 2024 Accepting new patients
Cornerstone Health Care PA Past Accepting new patients

Locations

1717 Main St
Ste 5850
Dallas, TX 75201
Phone (469) 694-5512

Interoperability endpoints

  • Direct secure messaging: pburke331768@ahs.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.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1437232675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1768 BUSINESS CENTER DR STE 100",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905359",
            "telephone_number": "800-762-9244",
            "fax_number": "786-672-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1768 BUSINESS CENTER DR STE 100",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905359",
            "telephone_number": "800-762-9244",
            "fax_number": "786-672-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "PAUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "KY",
            "license": "42328",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "200401476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901242",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.