Active NPI
Kenneth Burke, M.D.
- Internal Medicine Physician
- Deerfield Beach, FL
National Provider Identifier
1992893853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 67633
- Practice address
- 111 Jim Moran Blvd
Deerfield Beach, FL 33442-1701 - Phone
- (954) 429-2418
- Fax
- (954) 429-2389
- NPI assigned
- Oct 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 67633 | FL | Primary |
Addresses
Primary practice location
111 Jim Moran Blvd
Deerfield Beach, FL 33442-1701
Mailing address
111 Jim Moran Blvd
Deerfield Beach, FL 33442-1701
Phone (954) 429-2418
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260528001449 | FL | Order and Referring Only - Internal Medicine | 3375578529 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67633 | FL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992893853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 JIM MORAN BLVD",
"city": "DEERFIELD BEACH",
"state": "FL",
"postal_code": "334421701",
"telephone_number": "954-429-2418",
"fax_number": "954-429-2389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 JIM MORAN BLVD",
"city": "DEERFIELD BEACH",
"state": "FL",
"postal_code": "334421701",
"telephone_number": "954-429-2418",
"fax_number": "954-429-2389"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURKE",
"first_name": "KENNETH",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "67633",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deerfield Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.