DR. TARA DALE HULBERT BURKE (DO, FACOG) – Obstetrics & Gynecology Physician, NPI 1366734774

DR. TARA DALE HULBERT BURKE (DO, FACOG) is a healthcare provider. based in Salt lake city, Utah. specializing in OBSTETRICS/GYNECOLOGY. They hold the professional credentials DO, FACOG. They hold a License No. OP60785747 (WA). The NPI Number for DR. TARA DALE HULBERT BURKE (DO, FACOG) is 1366734774

Main info

Female
17 Years Of Experience
Accepts Medicare Assignment
Name
DR. TARA DALE HULBERT BURKE (DO, FACOG)
NPI
1366734774
Phone
(206) 320-4476
Address
PO BOX 25608
Enumeration Date
4 May 2011
Last Update Date
23 August 2023

Doctor Profile

Medical School Name
TOURO UN COLLEGE OF OSTEOPATHIC MEDICINE, VALLEJO
Secondary Phone
5413893300
Graduation Year
2009 (17 years ago)
PAC ID
7416190715
Group Practice PAC ID
9638166796
Professional Enrollment ID
I20230907000752
Address ID
OR977016752BE2400XRDXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:15State licenses:1Digital endpointsOther names

632 OBSTETRICS/GYNECOLOGY in OR

Provider Addresses for DR. TARA DALE HULBERT BURKE (DO, FACOG)

  • PO BOX 25608

    SALT LAKE CITY, UT 841250608

    Phone: (206) 320-4476

    Fax: (206) 568-7043

    Type: Mailing

  • 2400 NE NEFF RD STE A

    BEND, OR 977016752

    Phone: (541) 389-3300

    Fax: (541) 389-8115

    Type: Location

  • 1101 MADISON ST STE 700

    SEATTLE, WA 981043599

    Phone: (206) 215-6300

    Fax: (206) 215-6301

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $181.

Total Amount is formed as General ($181) + Research ($0) + Ownership ($0) = $181.

Last reported payment date: 2023-11-07 • Largest payer in this snapshot: Astellas Pharma US Inc ($125).

Total Amount

$181

General + Research + Ownership

Payments

3

Total payment records

General Amount

$181

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-11-07

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: 2023-09-07

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
I20230907000752IObstetrics/GynecologyORTBD

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 84125)

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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: 9638166796View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YOR
-OR
-OR
O B S T E T R I C S/ G Y N E C O L O G YOR
Physician AssistantOR
O B S T E T R I C S/ G Y N E C O L O G YOR
O B S T E T R I C S/ G Y N E C O L O G YNY
Certified Nurse Midwife (Cnm)AK
Certified Nurse Midwife (Cnm)OR
O B S T E T R I C S/ G Y N E C O L O G YOR

Reviews

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Frequently asked questions

How do I look up DR. TARA DALE HULBERT BURKE (DO, FACOG) by NPI?
Use NPI 1366734774 when you need to reference DR. TARA DALE HULBERT BURKE (DO, FACOG) in forms, claims, or directories.
Is DR. TARA DALE HULBERT BURKE (DO, FACOG) active in the national directory?
DR. TARA DALE HULBERT BURKE (DO, FACOG)'s public NPI profile is in an active state.
What field does DR. TARA DALE HULBERT BURKE (DO, FACOG) work in?
You can think of DR. TARA DALE HULBERT BURKE (DO, FACOG) as practicing within Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. TARA DALE HULBERT BURKE (DO, FACOG)?
The page summarizes Salt Lake City, Utah for DR. TARA DALE HULBERT BURKE (DO, FACOG); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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