Individual provider Active NPI

Paul E. Burk, D.O.

  • Facial Plastic Surgery Physician
  • Chesterfield, MO
National Provider Identifier
1790786838
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
R6G71 Issued in MO
Practice address
226 S Woods Mill Rd Ste 44W
Chesterfield, MO 63017-3442
Phone
(314) 447-4995
Fax
(314) 682-6093
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X R6G71 MO
Facial Plastic Surgery Physician 207YS0123X R6G71 MO Primary

Addresses

Primary practice location

226 S Woods Mill Rd Ste 44W
Chesterfield, MO 63017-3442

Mailing address

226 S Woods Mill Rd Ste 44W
Chesterfield, MO 63017-3442
Phone (314) 447-4995

Other identifiers 1

IdentifierTypeStateIssuer
242428308MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040326000885 MO Practitioner - Otolaryngology 6406751957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

226 S Woods Mill Rd
Suite 44W
Chesterfield, MO 63017-3442
Phone (314) 447-4995

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R6G71MOMDFacial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hodag Medical Services, LLC Current Accepting new patients
Ear Nose Throat Medical Service CurrentSince Dec 15, 2019 Accepting new patients
Metropolitan Plastic Surgery PC Past Accepting new patients

Locations

226 S Woods Mill Rd
Ste 44W
Chesterfield, MO 63017
Phone (314) 447-4995

1324 Clarkson Clayton Ctr
Ellisville, MO 63011
Phone (314) 735-5015

2325 Dougherty Ferry Rd
Ste 205
Saint Louis, MO 63122
Phone (314) 821-5002

2315 Dougherty Ferry Rd
Ste 103
Saint Louis, MO 63122
Phone (314) 821-5002

4800 Mexico Rd
Ste 103
Saint Peters, MO 63376
Phone (314) 821-5002

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1790786838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 S WOODS MILL RD STE 44W",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173442",
            "telephone_number": "314-447-4995",
            "fax_number": "314-682-6093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 S WOODS MILL RD STE 44W",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173442",
            "telephone_number": "314-447-4995",
            "fax_number": "314-682-6093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURK",
        "first_name": "PAUL",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MO",
            "license": "R6G71",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "MO",
            "license": "R6G71",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242428308",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.