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ROBERT MATTHEW BURKES
NPI 1104263623
Internal Medicine - Pulmonary Disease in Cincinnati, OH

Active since May 23, 2013PECOS EnrolledAccepts Medicare Assignment
78.78/100
CMS Quality Rating
234 GOODMAN ST, CINCINNATI, OH 45219(513) 475-8523(513) 475-7327 Get Directions Write a Review

NPPES record last updated: May 19, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Robert Matthew Burkes NPPES

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

ROBERT MATTHEW BURKES (NPI 1104263623) is an individual pulmonary disease provider in Cincinnati, Ohio, licensed in Ohio (35139435) and active in the NPI registry since May 2013. He is enrolled in Medicare PECOS, is affiliated with University Of Cincinnati Medical Center, Llc, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1104263623
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameROBERT MATTHEW BURKES
Location Address234 GOODMAN STCincinnati, OH 45219-2364
Mailing Address2830 Victory PkwyCincinnati, OH 45206-1785 · (513) 245-3072 · Fax (513) 585-5511
Phone(513) 475-8523
Fax(513) 475-7327
Sole ProprietorYes
Medical School CMSOtherGraduated 2013
Enumeration DateMay 23, 2013
Last NPPES UpdateMay 19, 2020
NPPES CertifiedMay 19, 2020
✔ NPI 1104263623 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License✔ Licensed in OH · 35139435
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
234 GOODMAN ST, Cincinnati, OH 45219
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, MedMutual, Molina Healthcare and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Robert Matthew Burkes is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3476854399
PECOS Enrollment IDI20200521003120
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.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
34 services32 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
27 services21 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
22 services14 patients
Test to examine how well the lungs exchange gases 94729
This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.
15 services15 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
14 services13 patients
Test to determine lung volumes using sensors 94726
This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.
12 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

University Of Cincinnati Medical Center, LLC

Acute Care Hospitals · Cincinnati, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360003
Location3188 Bellevue AvenueCincinnati, OH 45219 · Hamilton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45219 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

78.78/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality70.42
Promoting Interoperability100
Improvement Activities40
Cost58.86

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Nebulizer, with compressor E0570
DME-Other DME · category DE000N
2 suppliers42 claims45 services$3.88 avg. paid by Medicare
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613
DME-Drugs Administered Through DME · category DG006N
4 suppliers14 claims3,535 services$0.03 avg. paid by Medicare
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620
DME-Drugs Administered Through DME · category DG006N
2 suppliers13 claims2,220 services$0.09 avg. paid by Medicare
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626
DME-Drugs Administered Through DME · category DG000N
1 supplier12 claims720 services$0.71 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
6 suppliers23 claims23 services$23.78 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

ALEXANDER TOPALA MD
Anesthesiology
234 GOODMAN ST, MAIL LOCATION 0796
CINCINNATI, OH 45219
Hamilton County (513) 584-1000
MELISSA T WESLEY CRNA
Nurse Anesthetist, Certified Registered
234 GOODMAN ST
CINCINNATI, OH 45219
Hamilton County (513) 558-4194
DR. SAURABH CHANDRA MD
Internal Medicine (Critical Care Medicine)
234 GOODMAN ST
CINCINNATI, OH 45219
Hamilton County (513) 558-1000
JOSEPH D PANDISCIA PA-C
Physician Assistant
234 GOODMAN ST
CINCINNATI, OH 45219
Hamilton County (513) 475-8690
RACHEL BEAUPRE
Student in an Organized Health Care Education/Training Program
234 GOODMAN ST, THORACIC SURGERY
CINCINNATI, OH 45219
Hamilton County (513) 584-1387
KATIE DEAN
Nurse Anesthetist, Certified Registered
234 GOODMAN ST
CINCINNATI, OH 45219
Hamilton County (513) 558-4194
MICHELLE CHAPMAN
Anesthesiology
234 GOODMAN ST
CINCINNATI, OH 45219
Hamilton County (513) 558-6356
KAYLA BERTKE
Pharmacist
234 GOODMAN ST
CINCINNATI, OH 45219
Hamilton County (513) 584-3468

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Robert Burkes's NPI number?

The NPI number for Robert Burkes is 1104263623. It was assigned to this individual provider in the NPPES registry on May 23, 2013.

Where is Robert Burkes located?

Robert Burkes practices at 234 Goodman St, Cincinnati, OH 45219. The listed phone number is (513) 475-8523.

What is Robert Burkes's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Robert Burkes enrolled in Medicare?

Yes. Robert Burkes is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Robert Burkes accept?

Health plans from CareSource, MedMutual, Molina Healthcare and Oscar Health Insurance list Robert Burkes as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Robert Burkes affiliated with any hospitals?

According to CMS data, Robert Burkes is affiliated with University Of Cincinnati Medical Center, LLC.

When was this NPI record last updated?

The NPPES record for Robert Burkes was last updated on May 19, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.