ANTONIA G BURKE MD
NPI 1104130186
Student in an Organized Health Care Education/Training Program in Detroit, MI

Q: What is Antonia Burke's NPI number?

The NPI number for Antonia Burke is 1104130186. It was assigned to this individual provider in the NPPES registry on August 2, 2010.

Q: What is Antonia Burke's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Antonia Burke was last updated on May 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 02, 2010PECOS Enrolled

22101 MOROSS RD, DETROIT, MI 48236(313) 343-3400(313) 343-4056 Get Directions Write a Review

NPPES record last updated: May 18, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 18, 2025, Sep 25, 2024 (2 updates tracked since 2024).

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About Antonia G Burke Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANTONIA G BURKE MD (NPI 1104130186) is an individual student in an organized health care education/training program in Detroit, Michigan and active in the NPI registry since August 2010. She is enrolled in Medicare PECOS and maintains a secondary practice location in Grosse Pointe Woods.

NPPES Registry Identity

NPI1104130186

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameANTONIA G BURKECredential: MD

Location Address22101 MOROSS RDDetroit, MI 48236-2148

Mailing Address22101 Moross RdDetroit, MI 48236-2148 · (313) 343-3400 · Fax (313) 343-4056

Phone(313) 343-3400

Fax(313) 343-4056

Sole ProprietorNo

Enumeration DateAugust 2, 2010

Last NPPES UpdateMay 18, 20252 updates tracked since enumeration

NPPES CertifiedMay 18, 2025

✔ NPI 1104130186 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Also ListedSpeech-Language PathologistTaxonomy 235Z00000X

22101 MOROSS RD, Detroit, MI 48236

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Secondary Practice Location 1

Location 119251 Mack Ave Ste 340Grosse Pointe Woods, MI 48236-2891 · Phone (313) 343-3400 · Fax (313) 343-4056

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Antonia G Burke Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARY DECAROLIS LMSW, ACSW

Social Worker (Clinical)