Individual provider Active NPI

Nathan Burkle, D.O.

  • Family Medicine Physician
  • Greenfield, WI
National Provider Identifier
1861806382
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
125-064514 Issued in IL
Practice address
4455 S 108TH St
Greenfield, WI 53228-2504
Phone
(414) 427-5310
Fax
(414) 427-5311
NPI assigned
Jun 12, 2014
Last updated
Sep 26, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125-064514 IL Primary

Addresses

Primary practice location

4455 S 108TH St
Greenfield, WI 53228-2504

Mailing address

4455 S 108TH St
Greenfield, WI 53228-2504
Phone (414) 427-5310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20171018001091 WI Practitioner - Family Practice 2466756549 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

11211 W Lincoln Ave
West Allis, WI 53227-1035
Phone (414) 454-8300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125-064514ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Sep 12, 2017 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Sep 12, 2017 Accepting new patients
The Medical College of Wisconsin, Inc. Family Medicine Current Accepting new patients
Froedtert & the Medical College of Wisconsin Community Physicians Inc. Past Accepting new patients

Locations

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

4455 S 108th St
Milwaukee, WI 53228
Phone (414) 409-7593

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

11211 W Lincoln Ave
West Allis, WI 53227
Phone (414) 454-8300

Interoperability endpoints

  • Direct secure messaging: nburklemd212519@direct.froedtert.com

Organizations & group practices 4

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": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1861806382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 S 108TH ST",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532282504",
            "telephone_number": "414-427-5310",
            "fax_number": "414-427-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 S 108TH ST",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532282504",
            "telephone_number": "414-427-5310",
            "fax_number": "414-427-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKLE",
        "first_name": "NATHAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-12",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125-064514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

Verify at the official NPI Registry.