KELLY G BURKENSTOCK MD A PROFESSIONAL MEDICAL CORPORATION
NPI 1639328578
Internal Medicine in Mandeville, LA
About Kelly G Burkenstock Md A Professional Medical Corporation NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLY G BURKENSTOCK MD A PROFESSIONAL MEDICAL CORPORATION (NPI 1639328578) is a healthcare organization registered as an internal medicine in Mandeville, Louisiana and active in the NPI registry since September 2008. The organization lists Kelly G Burkenstock, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kelly G Burkenstock Md A Professional Medical Corporation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Kelly G Burkenstock MD A Professional Medical Corporation, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Kelly G Burkenstock MD A Professional Medical Corporation's NPI number?
The NPI number for Kelly G Burkenstock MD A Professional Medical Corporation is 1639328578. It was assigned to this organization in the NPPES registry on September 16, 2008.
Where is Kelly G Burkenstock MD A Professional Medical Corporation located?
Kelly G Burkenstock MD A Professional Medical Corporation is located at 2040 N Causeway Blvd, Mandeville, LA 70471. The listed phone number is (985) 727-7676.
What is Kelly G Burkenstock MD A Professional Medical Corporation's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Kelly G Burkenstock MD A Professional Medical Corporation enrolled in Medicare?
Yes. Kelly G Burkenstock MD A Professional Medical Corporation is registered in the Medicare PECOS enrollment system.
When is Kelly G Burkenstock MD A Professional Medical Corporation's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Louisiana, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Kelly G Burkenstock MD A Professional Medical Corporation?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Internal Medicine, reassign their Medicare billing to Kelly G Burkenstock MD A Professional Medical Corporation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Kelly G Burkenstock MD A Professional Medical Corporation accept?
Health plans from Blue Cross and Blue Shield of Louisiana and HMO Louisiana list Kelly G Burkenstock MD A Professional Medical Corporation 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.
When was this NPI record last updated?
The NPPES record for Kelly G Burkenstock MD A Professional Medical Corporation was last updated on July 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Kelly G Burkenstock Md A Professional Medical Corporation · NPI 1639328578
Internal Medicine organization in Mandeville, Louisiana. Organization record, active in the CMS NPPES registry since September 16, 2008.
## Identity
- **NPI:** 1639328578 (Entity type: Organization)
- **Enumerated:** September 16, 2008
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Kelly Burkenstock, PRESIDENT
## Practice location
- **Address:** 2040 N CAUSEWAY BLVD, Mandeville, LA 70471-3116
- **Phone:** (985) 727-7676 · **Fax:** (985) 727-3476
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, Louisiana, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians (Internal Medicine) reassign Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 19, 2022
- **Other identifiers:** Medicaid 1496278 (LA)
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Source: [NPI Profile](https://npiprofile.com/npi/1639328578) · Data from the CMS NPPES public registry.