Organization Active NPI

Burke Optometry, Inc.

Doing business as Burke Optometry

  • Optometrist
  • Lodi, CA
National Provider Identifier
1699047332
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9259 Issued in CA
Legal business name
BURKE OPTOMETRY, INC.
Doing business as
Burke Optometry
Practice address
441 S Ham LN
Suite B
Lodi, CA 95242-3525
Phone
(209) 224-5454
NPI assigned
Jan 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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

Authorized official

Name
Dr. Germaine N Burke, O.D.NPI 1376628404
Title
Optometrist/Co-Owner
Phone
(209) 224-5454

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 9259 CA Primary

Addresses

Primary practice location

441 S Ham LN
Suite B
Lodi, CA 95242-3525

Mailing address

441 S. Ham Lane
Suite B
Lodi, CA 95242
Phone (209) 224-5454

Other names 1

  • Burke Optometry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120807000352 CA Part B Supplier - Clinic/Group Practice 8729234703 Receives reassigned benefits from 3 practitioners
Practice locations: Lodi, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Burke Optometry441 S Ham LN, Lodi, CA 95242-3525(209) 224-5454 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jul 20, 2012

National Provider Directory

National Provider Directory

Locations

441 S Ham Ln
Ste B
Lodi, CA 95242
Phone (209) 224-5454

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1327536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672963200000",
    "number": "1699047332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 S. HAM LANE",
            "address_2": "SUITE B",
            "city": "LODI",
            "state": "CA",
            "postal_code": "95242",
            "telephone_number": "209-224-5454",
            "fax_number": "209-224-8791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 S HAM LN",
            "address_2": "SUITE B",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423525",
            "telephone_number": "209-224-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURKE OPTOMETRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-26",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "GERMAINE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OPTOMETRIST/CO-OWNER",
        "authorized_official_telephone_number": "209-224-5454",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Burke Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.