Individual provider Active NPI

Igor Burko

  • Plastic Surgery Physician
  • Staten Island, NY
National Provider Identifier
1982022323
Registry record updated Mar 19, 2024
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Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
324049 Issued in NY
Practice address
20 Father Capodanno Blvd Apt 6H
Staten Island, NY 10305-4826
Phone
(347) 816-0253
NPI assigned
Apr 2, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 324049 NY Primary

Addresses

Primary practice location

20 Father Capodanno Blvd Apt 6H
Staten Island, NY 10305-4826

Mailing address

20 Father Capodanno Blvd Apt 6H
Staten Island, NY 10305-4826
Phone (347) 816-0253

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240329000900 NY Practitioner - Plastic and Reconstructive SurgeryPractitioner - General SurgeryPractitioner - General Practice 3577809342

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
324049NYMDPlastic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1982022323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 FATHER CAPODANNO BLVD APT 6H",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054826",
            "telephone_number": "347-816-0253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 FATHER CAPODANNO BLVD APT 6H",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054826",
            "telephone_number": "347-816-0253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKO",
        "first_name": "IGOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-02",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "324049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.