Individual provider Active NPI

Dennis A. Burke, D.O.

  • Neuromusculoskeletal Medicine & OMM Physician
  • Lewisburg, WV
National Provider Identifier
1508975798
Registry record updated Apr 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
2786 Issued in WV
Practice address
400 N Jefferson St
Lewisburg, WV 24901
Phone
(304) 645-3220
Fax
(304) 645-4103
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 2786 WV Primary

Addresses

Primary practice location

400 N Jefferson St
Lewisburg, WV 24901

Mailing address

400 N Jefferson St
Lewisburg, WV 24901
Phone (304) 645-3220

Other identifiers 1

IdentifierTypeStateIssuer
3810026766MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040319000830 CT Practitioner - Osteopathic Manipulative Medicine 8426948522 Reassigns benefits to 2 organizations
I20040503000069 NY Practitioner - Osteopathic Manipulative Medicine 8426948522 Practice locations: Fishkill, NY

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians
Prospect CT Medical Foundation IncGroup PAC ID 7416244496, 287 clinicians

Practice addresses (Care Compare)

1244 Storrs Rd
Road
Storrs, CT 06268-2200
Phone (860) 724-2579

945 Main St
Suite 203
Manchester, CT 06040-6064
Phone (860) 871-6710

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2786WVMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Access P.C. Current Accepting new patients
Prospect CT Medical Foundation, Inc. CurrentSince Nov 1, 2024 Accepting new patients

Locations

1801 W Olympic Blvd
#2201
Pasadena, CA 91199

945 Main St
Ste 203
Manchester, CT 06040
Phone (860) 646-1011

18 Haynes St
Uppr
Manchester, CT 06040
Phone (860) 649-7557

945 Main St
Manchester, CT 06040
Phone (860) 646-6383

130 Hartford Rd
Manchester, CT 06040
Phone (860) 533-4673

Interoperability endpoints

  • Direct secure messaging: dburke18880@sbhny.direct-ci.net
  • Direct secure messaging: dennisburke@mpp.allscriptsdirect.net

Organizations & group practices 3

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 1

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398729600000",
    "number": "1508975798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N JEFFERSON ST",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "24901",
            "telephone_number": "304-645-3220",
            "fax_number": "304-645-4103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N JEFFERSON ST",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "24901",
            "telephone_number": "304-645-3220",
            "fax_number": "304-645-4103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "DENNIS",
        "middle_name": "A.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2014-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "WV",
            "license": "2786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810026766",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisburg, WV

Sources for this page

Verify at the official NPI Registry.