Derek Burkum, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4501 Issued in AZ

Practice address

3929 E Bell Rd
Phoenix, AZ 85032-2112

Phone

(602) 923-5622

NPI assigned

Oct 22, 2007

Last updated

Mar 8, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI, NY2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dburkum784953@direct.emplifyhealth.org

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.

• Black River Health Inc

  • Critical Access Hospital
  • Black River Falls, WI
  • NPI 1811940331
  Medicare reassignment NPD
• Vernon Memorial Healthcare, Inc.

  dba Vernon Health

  • Critical Access Hospital
  • Viroqua, WI
  • NPI 1497750921
  Medicare reassignment NPD
• Nes Medical Services of New York PC

  • Emergency Medicine Physician
  • Bath, NY
  • NPI 1215455191
  Medicare reassignment
• Tri-City Express Care, PLLC

  dba FastMed Urgent Care

  • Family Medicine Physician
  • Mesa, AZ
  • NPI 1649554940
  NPD
• Black River Health Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Black River Falls, WI
  • NPI 1003914011
  NPD
• Black River Health Inc

  dba Black River Healthcare Clinic

  • Rural Health Clinic/Center
  • Black River Falls, WI
  • NPI 1255183182
  NPD
• Nes Medical Services of New York PC

  • Emergency Medicine Physician
  • Elmira, NY
  • NPI 1831742816
  NPD
• Comprehensive Hospitalist Services of Arizona LLC

  • Hospitalist Physician
  • Mesa, AZ
  • NPI 1689909780
  NPD (past)
• Comprehensive Hospitalist Services of Arizona, LLC

  • Hospitalist Physician
  • Bullhead City, AZ
  • NPI 1265823215

  Physician Assistant

  NPD (past)
• Vernon Memorial Healthcare, Inc.

  dba Kickapoo Valley Medical Clinic - VMH

  • Rural Health Clinic/Center
  • Soldiers Grove, WI
  • NPI 1376549824
  NPD (past)

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1760671200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3807 N 87TH ST",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852515032",
            "telephone_number": "602-531-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3929 E BELL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322112",
            "telephone_number": "602-923-5622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKUM",
        "first_name": "DEREK",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-22",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "4501",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9104392",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veronica Burklow
• Kyle Bradley Burklund, OTR/L
• Angela Marianna Burks, LCSW
• Emily Ann Burks, LMSW
• Teresa Lynn Burks, NP, APN
• Michele M Burleson, MD
• Grafton Jeremy Burley, DPT
• Lissette Marie Burley, PHLEBOTOMIST
• Lori Burmeister, PHD
• Eric S. Burness, DPT

• Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.