NICHOLAS ANTONIO BURKE – Emergency Medicine Physician, NPI 1174144364

NICHOLAS ANTONIO BURKE is a healthcare provider. based in Mount vernon, Illinois. specializing in EMERGENCY MEDICINE. They hold a License No. 036165520 (IL). The NPI Number for NICHOLAS ANTONIO BURKE is 1174144364

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
NICHOLAS ANTONIO BURKE
NPI
1174144364
Phone
(618) 242-4600
Address
1 GOOD SAMARITAN WAY
Enumeration Date
29 April 2020
Last Update Date
3 November 2023

Doctor Profile

Medical School Name
AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Secondary Phone
6182424600
Graduation Year
2020 (6 years ago)
PAC ID
3476974270
Group Practice PAC ID
1658529342
Professional Enrollment ID
I20230918004082
Address ID
IL628642402MO1XXXXWAYX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:6State licenses:1Digital endpointsOther names

2,845 EMERGENCY MEDICINE in IL

Provider Addresses for NICHOLAS ANTONIO BURKE

  • 1 GOOD SAMARITAN WAY

    MOUNT VERNON, IL 628642402

    Phone: (618) 242-4600

    Type: Location

  • 4201 SAINT ANTOINE ST

    DETROIT, MI 482012153

    Phone: (313) 966-3841

    Fax: (313) 966-1024

    Type: Mailing

  • 58654 VALLEY VIEW DR

    WASHINGTON, MI 480940901

    Phone: (586) 246-0714

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2023-09-18

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
I20230918004082IEmergency MedicineILTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making126126$0
99284Emergency department visit with moderate level of medical decision making2827$0
View full utilization report →

Insurance plans in this area (ZIP 62864)

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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: 1658529342View full group profile
NameSpecialtyState
Nurse PractitionerIL
Emergency MedicineIN
Emergency MedicineTX
Emergency MedicineIL
Emergency MedicineMO
Emergency MedicineIL
-IL
Nurse PractitionerIL
Emergency MedicineCA
Nurse PractitionerIL

Reviews

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Frequently asked questions

Is there an official ID for NICHOLAS ANTONIO BURKE in U.S. healthcare records?
The official identifier for NICHOLAS ANTONIO BURKE is NPI 1174144364.
Would NICHOLAS ANTONIO BURKE appear as active to a payer?
You can treat NICHOLAS ANTONIO BURKE as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is NICHOLAS ANTONIO BURKE?
NICHOLAS ANTONIO BURKE is associated with Emergency Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with NICHOLAS ANTONIO BURKE?
Directory geography for NICHOLAS ANTONIO BURKE centers on Mount Vernon, Illinois.
When was this NPI issued?
Enumeration for NICHOLAS ANTONIO BURKE is noted as April 29, 2020 where the registry provides it.

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