Individual provider Active NPI

Bruce A Burkeen, PA-C

  • Physician Assistant
  • Ann Arbor, MI
National Provider Identifier
1649209354
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601003027 Issued in MI
Practice address
2500 Packard St Ste 104a
Ann Arbor, MI 48104-6827
Phone
(734) 707-1052
Fax
(734) 661-1887
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 798 TN
Physician Assistant 363A00000X 5601003027 MI Primary

Addresses

Primary practice location

2500 Packard St Ste 104a
Ann Arbor, MI 48104-6827

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 936-4000

Other practice location 1

2970 E Lake Lansing Rd
East Lansing, MI 48823-7415
Phone (734) 707-1052

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050517000045 TN Practitioner - Physician Assistant 5193766517
I20180409000443 MI Practitioner - Physician Assistant 5193766517 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrative ServicesGroup PAC ID 5092081687, 7 clinicians

Practice addresses (Care Compare)

2500 Packard St
Suite 104a
Ann Arbor, MI 48104-6827
Phone (734) 707-1052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Service Corporation CurrentSince Jan 28, 2019 Accepting new patients
Iha Health Services Corporation CurrentSince Jan 28, 2019 Accepting new patients
Carespot of Nashville (West End Avenue), LLC Current Accepting new patients
Emcare Physician Providers, Inc. Past Accepting new patients
TN-I Medical Services PC Physician Assistant Past Accepting new patients
Carespot of Lebanon 1705 West Main Street LLC Past Accepting new patients
Ehra Medical Services of Tennessee PC Past Accepting new patients
Urgent Care Enterprise LLC PastSince Jul 1, 2017 Accepting new patients
Tennessee Em-I Medical Services PC Physician Assistant Past Accepting new patients

Locations

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

1255 E M 36
Pinckney, MI 48169
Phone (734) 878-1000

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

3404 West End Ave
Ste 101
Nashville, TN 37203
Phone (615) 866-4238

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1649209354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-936-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 PACKARD ST STE 104A",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481046827",
            "telephone_number": "734-707-1052",
            "fax_number": "734-661-1887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2970 E Lake Lansing Rd",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488237415",
            "country_code": "US",
            "telephone_number": "734-707-1052",
            "fax_number": "734-661-1887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURKEEN",
        "first_name": "BRUCE",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "798",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.