Kelby Borchgrevink

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

63438 Issued in CA

Practice address

3425 N 1St St
Fresno, CA 93726-6821

Phone

(559) 608-6581

NPI assigned

Jul 10, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Woodlake, CA
  • NPI 1164517744
  Medicare reassignment
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Delano, CA
  • NPI 1063283158
  NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Fresno, CA
  • NPI 1225546575
  NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Ivanhoe, CA
  • NPI 1386670610
  NPD (past)

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1023530219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4908 BRAHMA ST",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827188503",
            "telephone_number": "307-257-3417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 N 1ST ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937266821",
            "telephone_number": "559-608-6581"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4989 N 3rd St",
            "address_purpose": "LOCATION",
            "city": "Laramie",
            "state": "WY",
            "postal_code": "820729548",
            "country_code": "US",
            "telephone_number": "307-745-8997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORCHGREVINK",
        "first_name": "KELBY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-10",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "63438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raha Borazjani, PA-C
• Brett Anthony Borba, PHARM.D.
• Karisa M Borba, O.D.
• Sean Patrick Borboa
• Harold Drew Borchardt, PA-C
• Heather Marie Borges
• Wynter Borgeson
• Sebastian Borja
• Debra L Borjas
• Sam Borno, MD

• Physician Assistant in Fresno, CA
• Providers in Fresno, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.