Individual provider Active NPI

Thomas O Burkholder, MD

  • Ophthalmology Physician
  • Allentown, PA
National Provider Identifier
1760425581
Registry record updated Sep 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD017300E Issued in PA
Practice address
400 N 17TH St
Ste 101
Allentown, PA 18104
Phone
(610) 433-0450
Fax
(610) 433-4655
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD017300E PA Primary

Addresses

Primary practice location

400 N 17TH St
Ste 101
Allentown, PA 18104

Mailing address

400 N 17TH St
Ste 101
Allentown, PA 18104
Phone (610) 433-0450

Other identifiers 1

IdentifierTypeStateIssuer
0596288MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Eye Center, P.C. Past Accepting new patients

Organizations & group practices 1

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379980800000",
    "number": "1760425581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N 17TH ST",
            "address_2": "STE 101",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "18104",
            "telephone_number": "610-433-0450",
            "fax_number": "610-433-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N 17TH ST",
            "address_2": "STE 101",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "18104",
            "telephone_number": "610-433-0450",
            "fax_number": "610-433-4655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHOLDER",
        "first_name": "THOMAS",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2013-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD017300E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0596288",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.