Individual provider Active NPI

Craig G Burkhart, M.D.

  • Dermatology Physician
  • Sylvania, OH
National Provider Identifier
1962405332
Registry record updated May 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
35042672 Issued in OH
Practice address
5600 Monroe St
Ste 106B
Sylvania, OH 43560-2728
Phone
(419) 885-3403
Fax
(419) 885-3401
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 35042675 OH
Dermatology Physician 207N00000X 35042672 OH Primary

Addresses

Primary practice location

5600 Monroe St
Ste 106B
Sylvania, OH 43560-2728

Mailing address

5600 Monroe St
Ste 106B
Sylvania, OH 43560-2728
Phone (419) 885-3403

Other identifiers 1

IdentifierTypeStateIssuer
0395666MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20071218000386 OH Practitioner - Dermatology 0840380507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Toledo College of Medicine, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5600 Monroe St
Suite B106
Sylvania, OH 43560-2728
Phone (419) 885-3403

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1569
Removal or shaving of skin growth142

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35042675OHMDSpecialist
35042672OHMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Craig G. Burkhart, M.D., Inc. Dermatology CurrentSince Aug 15, 1982 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

5600 Monroe St
Ste B106
Sylvania, OH 43560
Phone (419) 885-3403

5600 Monroe St
Ste 106B
Sylvania, OH 43560
Phone (419) 885-3403

Organizations & group practices 2

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 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": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305849600000",
    "number": "1962405332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 MONROE ST",
            "address_2": "STE 106B",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602728",
            "telephone_number": "419-885-3403",
            "fax_number": "419-885-3401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 MONROE ST",
            "address_2": "STE 106B",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602728",
            "telephone_number": "419-885-3403",
            "fax_number": "419-885-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHART",
        "first_name": "CRAIG",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2011-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "35042675",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35042672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0395666",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

Verify at the official NPI Registry.