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DR. ASHLEY A BURKHOLDER DO
NPI 1376930073
Family Medicine - Hospice and Palliative Medicine in Sandusky, OH

Active since April 20, 2015PECOS EnrolledAccepts Medicare Assignment
85.15/100
CMS Quality Rating
1912 HAYES AVE, SANDUSKY, OH 44870(419) 557-7070 Get Directions Write a Review

NPPES record last updated: February 12, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 5, 2023, Aug 21, 2018 (2 updates tracked since 2018).

About Dr. Ashley A Burkholder Do NPPES

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

DR. ASHLEY A BURKHOLDER DO (NPI 1376930073) is an individual hospice and palliative medicine provider in Sandusky, Ohio, licensed in Ohio (34.014412) and active in the NPI registry since April 2015. She is enrolled in Medicare PECOS, is affiliated with Firelands Regional Medical Center, and is a graduate of Ohio University, College Of Osteopathic Medicine (2015).

NPPES Registry Identity

NPI1376930073
Entity TypeIndividualFemale
Primary Taxonomy207QH0002X
Provider Legal NameDR. ASHLEY A BURKHOLDERCredential: DO
Location Address1912 HAYES AVESandusky, OH 44870-4736
Mailing Address1912 Hayes AveSandusky, OH 44870-4736 · (419) 557-7070
Phone(419) 557-7070
Sole ProprietorNo
Medical School CMSOhio University, College Of Osteopathic MedicineGraduated 2015
Enumeration DateApril 20, 2015
Last NPPES UpdateFebruary 12, 20242 updates tracked since enumeration
NPPES CertifiedFebruary 12, 2024
✔ NPI 1376930073 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Hospice and Palliative MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QH0002X
License✔ Licensed in OH · 34.014412
Definition
A family medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care.
1912 HAYES AVE, Sandusky, OH 44870
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, MedMutual.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

Dr. Ashley A Burkholder Do 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 ID8921312554
PECOS Enrollment IDI20230928004014
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.

Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
76 services41 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
54 services35 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.
39 services25 patients
Advance care planning, each additional 30 minutes 99498
Advance care planning involves discussing and documenting your future health care preferences in case you're unable to make decisions for yourself. Each additional 30 minutes allows more time to explore your wishes, values, and goals for treatment.
22 services16 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
14 services14 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
14 services14 patients

Hospital Affiliations CMS Care Compare

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

Firelands Regional Medical Center

Acute Care Hospitals · Sandusky, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360025
Location1111 Hayes AvenueSandusky, OH 44870 · Erie County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44870 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
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.

85.15/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality62.59
Improvement Activities40
Cost67.06

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.

RICHARD S SCARBOROUGH D.O.
Pathology (Anatomic Pathology & Clinical Pathology)
1912 HAYES AVE
SANDUSKY, OH 44870
Erie County (419) 557-7189
DANIEL MATOS
Licensed Practical Nurse
1912 HAYES AVE
SANDUSKY, OH 44870
Erie County (419) 609-1460
KIMBERLY OLLOM
Social Worker
1912 HAYES AVE
SANDUSKY, OH 44870
Erie County (419) 502-2800
SOPHIA MARIE HANSON LISW
Social Worker (Clinical)
1912 HAYES AVE
SANDUSKY, OH 44870
Erie County (419) 502-2800
MR. WILLIAM J SOLAK RN
Registered Nurse (Ambulatory Care)
1912 HAYES AVE
SANDUSKY, OH 44870
Erie County (440) 934-9158
KENDALL RAE KASPER RD
Dietitian, Registered
1912 HAYES AVE
SANDUSKY, OH 44870
Erie County (419) 502-2800
FIRELANDS REGIONAL MEDICAL CENTER FAMILY PRACTICE CLINIC
Clinic/Center (Primary Care)
1912 HAYES AVE
SANDUSKY, OH 44870
Erie County (419) 557-7184
CLEVELAND VAMC
Clinic/Center (VA)
1912 HAYES AVE
SANDUSKY, OH 44870
Erie County (608) 821-7200

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 Ashley Burkholder's NPI number?

The NPI number for Ashley Burkholder is 1376930073. It was assigned to this individual provider in the NPPES registry on April 20, 2015.

Where is Ashley Burkholder located?

Ashley Burkholder practices at 1912 Hayes Ave, Sandusky, OH 44870. The listed phone number is (419) 557-7070.

What is Ashley Burkholder's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Hospice and Palliative Medicine, with taxonomy code 207QH0002X.

Is Ashley Burkholder enrolled in Medicare?

Yes. Ashley Burkholder 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 Ashley Burkholder accept?

Health plans from CareSource and MedMutual list Ashley Burkholder 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 Ashley Burkholder affiliated with any hospitals?

According to CMS data, Ashley Burkholder is affiliated with Firelands Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Ashley Burkholder was last updated on February 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.