ERIKA J BURKE M.D.
NPI 1245551035
Family Medicine in Denver, CO


Quality Rating: 94.73 out of 100 score

NPI Status: Active since June 16, 2010

Contact Information

777 BANNOCK ST
DENVER, CO
ZIP 80204
Phone: (303) 602-3300

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  • Individual
  • Female
  • Years of Experience 16
  • Family Medicine
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About ERIKA BURKE

This page provides the complete NPI Profile along with additional information for Erika Burke, a primary care provider established in Denver, Colorado with a medical specialization in Family Medicine and more than 16 years of experience. The healthcare provider is registered in the NPI registry with number 1245551035 assigned on June 2010. The practitioner's primary taxonomy code is 207Q00000X with license number DR.0051576 (CO). The provider is registered as an individual and her NPI record was last updated 5 years ago.

NPI
1245551035
Provider Name
ERIKA J BURKE M.D.
Gender
Female
Entity Type
Individual
Location Address
777 BANNOCK ST DENVER, CO 80204
Location Phone
(303) 602-3300
Mailing Address
777 BANNOCK ST DENVER, CO 80204
Mailing Phone
(303) 602-3300
Medical School Name
OTHER
Graduation Year
2010
Is Sole Proprietor?
No
Enumeration Date
06-16-2010
Last Update Date
01-26-2021
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A primary care provider (PCP) like Erika Burke sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
DR.0051576
License State
CO
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207Q00000XAllopathic & Osteopathic Physicians

Family Medicine

04-38609 (KS)
2390200000XStudent, Health Care

Student in an Organized Health Care Education/Training Program

TL-3635 (CO)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
09858571MEDICAID (05)CO 

Medicare Participation & PECOS Enrollment Status

Erika Burke is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Erika Burke is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 446402820

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20121211000245

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 20-29 minutes

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.

This service was performed 15 times for 15 patients

Established patient office or other outpatient visit, 30-39 minutes

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.

This service was performed 24 times for 21 patients

Follow-up hospital inpatient care per day, typically 25 minutes

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.

This service was performed 46 times for 14 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $22.35 for a new patient copayment and $25.5 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 80204 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $89.43
  • Minimum New Patient Price $58.06
  • Maximum New Patient Price $174.82
  • Average New Patient Copayment $22.35
  • Minimum New Patient Copayment $14.51
  • Maximum New Patient Copayment $43.7

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $102.03
  • Minimum Established Patient Price $18.88
  • Maximum Established Patient Price $142.79
  • Average Established Patient Copayment $25.5
  • Minimum Established Patient Copayment $4.72
  • Maximum Established Patient Copayment $35.69

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 94.73, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 94.73 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 81.44

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 84

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: 86.9

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: 86.9

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Reviews for ERIKA J BURKE M.D.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1245551035
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2285105206
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 8 + 5 + 1 + 0 + 5 + 2 + 0 + 6 + 24 = 55
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 55 = 55

The NPI number 1245551035 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

DR. WALTER L. BIFFL MD

Surgery

777 BANNOCK ST
MC 0206
DENVER, CO
ZIP 80204

(303) 436-5842

DR. ERIC PETERSON MD

Family Medicine

777 BANNOCK ST
VC 1914
DENVER, CO
ZIP 80204

(303) 436-6000

MARGARET TOMCHO MD

Pediatrics

777 BANNOCK ST
MC 3000
DENVER, CO
ZIP 80204

(303) 436-4320

DR. JOHN C HOLLAND M.D.

Psychiatry & Neurology

(Psychiatry)

777 BANNOCK ST
DENVER, CO
ZIP 80204

(720) 236-2390

NORMA J STIGLICH M.D.

Obstetrics & Gynecology

777 BANNOCK ST
MC 3240
DENVER, CO
ZIP 80204

(303) 436-6000

DR. CHARLES A SHUMAN MD

Psychiatry & Neurology

(Psychiatry)

777 BANNOCK ST
UNIT 9
DENVER, CO
ZIP 80204

(303) 436-7777

SHEILA ANNE LORENTZEN C.N.M.

Advanced Practice Midwife

777 BANNOCK ST
DENVER, CO
ZIP 80204

(970) 231-4012

PAULINE FRANCES CONNOR CNM, NP

Nurse Practitioner

(Obstetrics & Gynecology)

777 BANNOCK ST
MC 1914
DENVER, CO
ZIP 80204

(303) 436-6000

DR. PHILIP SYDNEY MEHLER MD

Internal Medicine

777 BANNOCK ST
MC 0278
DENVER, CO
ZIP 80204

(303) 436-3234

RICHARD L BYYNY MD

Emergency Medicine

777 BANNOCK ST
MC 7782
DENVER, CO
ZIP 80204

(303) 436-6000

STEPHEN M HESSL MD

Preventive Medicine

(Occupational Medicine)

777 BANNOCK ST
MC 7782
DENVER, CO
ZIP 80204

(303) 436-6000

PHILIP F STAHEL MD

Orthopaedic Surgery

(Orthopaedic Trauma)

777 BANNOCK ST
MC 7782
DENVER, CO
ZIP 80204

(303) 436-6000

DAVID S BRODY MD

Internal Medicine

777 BANNOCK ST
MC 7782
DENVER, CO
ZIP 80204

(303) 436-6000

KATHRYN M BEAUCHAMP MD

Neurological Surgery

777 BANNOCK ST
MC 7782
DENVER, CO
ZIP 80204

(303) 426-6000

BARBARA QUIST

Nurse Anesthetist, Certified Registered

777 BANNOCK ST
MAIL CODE
DENVER, CO
ZIP 80204

(303) 570-4595

FRED SINGER

Nurse Anesthetist, Certified Registered

777 BANNOCK ST
DENVER, CO
ZIP 80204

(303) 436-6550

SUZANNE Z BARKIN MD

Radiology

(Diagnostic Radiology)

777 BANNOCK ST
MC 7782
DENVER, CO
ZIP 80204

(303) 436-6000

MONA B KRULL MD

Obstetrics & Gynecology

777 BANNOCK ST
MC 7782
DENVER, CO
ZIP 80204

(303) 436-6000

MERRIBETH BRUNTZ DPM

Podiatrist

777 BANNOCK ST
MC 7782
DENVER, CO
ZIP 80204

(303) 436-6000

MAGDALENA M AGUAYO PA

Physician Assistant

777 BANNOCK ST
MC 7782
DENVER, CO
ZIP 80204

(303) 436-6000

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1245551035, enumerated as an "individual" on June 16, 2010.

The provider is located at 777 BANNOCK ST DENVER, CO 80204 and the phone number is (303) 602-3300.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.