Individual provider Active NPI

Riley James Burkert

  • Physician Assistant
  • Cincinnati, OH
National Provider Identifier
1659140945
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.PENDING Issued in OH
Practice address
3130 Highland Ave
Cincinnati, OH 45219-2399
Phone
(513) 475-8500
NPI assigned
Dec 27, 2023
Last updated
Jun 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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 50.PENDING OH Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

3130 Highland Ave
Cincinnati, OH 45219-2399

Mailing address

PO Box 636256
Cincinnati, OH 45263-6256
Phone (513) 585-6200

Other practice location 1

4891 Destination Ct Unit 102
West Chester, OH 45069-7088
Phone (812) 614-1072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240918001352 OH Practitioner - Physician Assistant 3870034895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3188 Bellevue Ave
Cincinnati, OH 45219-2369
Phone (513) 584-1000

3229 Burnet Ave
Cincinnati, OH 45229-3018
Phone (513) 584-4268

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.PENDINGOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Cincinnati Medical Center, LLC Physician Assistant Current Accepting new patients

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.

Hospital & facility affiliations 2

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": "1703635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1659140945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636256",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636256",
            "telephone_number": "513-585-6200",
            "fax_number": "513-245-3672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 HIGHLAND AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192399",
            "telephone_number": "513-475-8500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4891 Destination Ct Unit 102",
            "address_purpose": "LOCATION",
            "city": "West Chester",
            "state": "OH",
            "postal_code": "450697088",
            "country_code": "US",
            "telephone_number": "812-614-1072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURKERT",
        "first_name": "RILEY",
        "middle_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-27",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.PENDING",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.