SALLY A BURTLE (M.D.) – Dermatology Physician, NPI 1821093972

SALLY A BURTLE (M.D.) is a healthcare provider. based in Richmond, California. specializing in DERMATOLOGY. They hold the professional credentials M.D.. They hold a License No. MD422621 (PA). The NPI Number for SALLY A BURTLE (M.D.) is 1821093972

Main info

Female
26 Years Of Experience
Accepts Medicare Assignment
Name
SALLY A BURTLE (M.D.)
NPI
1821093972
Phone
(510) 307-2372
Address
901 NEVIN AVE
Enumeration Date
16 June 2005
Last Update Date
13 December 2021

Doctor Profile

Medical School Name
HAHNEMANN UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
7076511000
Graduation Year
2000 (26 years ago)
PAC ID
7719957505
Group Practice PAC ID
8921910225
Professional Enrollment ID
I20070501000351
Address ID
CA945892441VA975XXDRXX300

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience63
Completeness85
Years active:20State licenses:2Other namesUpdated within 12 months

2,140 DERMATOLOGY in CA

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Provider Addresses for SALLY A BURTLE (M.D.)

  • Kaiser Permanente Richmond Medical Center, 901, Nevin Avenue, Iron Triangle, Richmond, Contra Costa County, California, 94801, United States

    RICHMOND, CA 948013143

    Phone: (510) 307-2372

    Fax: (510) 307-2374

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 8 Open Payments records for all available years, with a total value of $302.

Total Amount is formed as General ($302) + Research ($0) + Ownership ($0) = $302.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: PFIZER INC. ($172).

Total Amount

$302

General + Research + Ownership

Payments

8

Total payment records

General Amount

$302

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-05-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070501000351IDermatologyCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 94801)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8921910225View full group profile
NameSpecialtyState
Emergency MedicineDC
-CA
N E U R O S U R G E R YMA
Internal MedicineCA
Nurse PractitionerCA
Internal MedicineCA
-MA
Emergency MedicineCA
-CA
Internal MedicineNY

Reviews

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Frequently asked questions

How is SALLY A BURTLE (M.D.) identified in CMS data?
CMS-hosted NPPES data lists SALLY A BURTLE (M.D.) with NPI 1821093972.
Does the file indicate SALLY A BURTLE (M.D.) is practicing under active NPI?
Directory data currently reports SALLY A BURTLE (M.D.) as active.
What is SALLY A BURTLE (M.D.)'s specialty?
The listing groups SALLY A BURTLE (M.D.) with Dermatology Physician. Clinical services aligned with this taxonomy classification.
Does SALLY A BURTLE (M.D.) list a practice location?
Patients near Richmond, California may find SALLY A BURTLE (M.D.) in results; validate coverage separately.
Why does SALLY A BURTLE (M.D.) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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