Michael Borja, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

9601146 Issued in NC

Practice address

2117 Simonton Rd
Suite 402
Statesville, NC 28625-8206

Phone

(704) 871-2323

Fax

(803) 619-2149

NPI assigned

Aug 25, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IFDDBA/Endpoint/IFDDBA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northlake Pediatric Care PA

  • Pediatrics Physician
  • Statesville, NC
  • NPI 1083729701
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369872000000",
    "number": "1023125861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2117 SIMONTON RD",
            "address_2": "SUITE 402",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286258206",
            "telephone_number": "704-871-2323",
            "fax_number": "803-619-2149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2117 SIMONTON RD",
            "address_2": "SUITE 402",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286258206",
            "telephone_number": "704-871-2323",
            "fax_number": "803-619-2149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORJA",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2013-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "9601146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3217120",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891002P",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "1002P",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7904102",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alisha Bolton, FNP
• Melissa Bonilla, FNP-BC
• Kay J Bontrager, LPC
• Kelly Ann Boone, FNP
• Sarah G. Borders, LPC
• Naim Ezzat Bouhussein, M.D.
• Michael Antoine Boulware, LCSW
• Shirley Anne Bowles, ED.D.
• Danita Bowling, J.D., PH.D.
• Janine Lynne Bowman, PHD

• Pediatrics Physician in Statesville, NC
• Providers in Statesville, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.