Active NPI
Michael Anthony P Borromeo, M.D.
- Internal Medicine Physician
- Red Lake, MN
National Provider Identifier
1063447605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 43108
- Practice address
- Highway 1
IHS Box 165
Red Lake, MN 56671-0165 - Phone
- (218) 679-3912
- Fax
- (218) 679-0181
- NPI assigned
- Jul 12, 2006
- Last updated
- Nov 7, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 43108 | MN | Primary |
Addresses
Primary practice location
Highway 1
IHS Box 165
Red Lake, MN 56671-0165
Mailing address
24760 Hospital Drive
Box 497
Red Lake, MN 56671-0165
Phone (218) 679-3912
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34G20BO | Other | MN | BC/BS OF MN |
| HSZ011 | Other | MN | PART B |
| HSZ009 | Other | MN | PART B |
| 510010100 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
24760 Hospital Dr
Redlake, MN 56671-0497
Phone 2186793912108
PO Box
Suite 497
Red Lake, MN 56671-0497
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43108 | MN | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PHS Indian Hospital | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Sanford Bemidji
- Ambulatory Surgical Clinic/Center
- Bemidji, MN
- NPI 1093876922
Hospital
-
dba Joe Lueken Cancer Center
- Internal Medicine Physician
- Bemidji, MN
- NPI 1780628149
Hospital
-
dba Sanford Bemidji Medical Center
- Rural Acute Care Hospital
- Bemidji, MN
- NPI 1801870191
-
dba Sanford 1717 Medical Building
- Family Medicine Physician
- West Fargo, ND
- NPI 1184917924
Hospital
-
dba Sanford Physical Therapy
- General Acute Care Hospital
- Fargo, ND
- NPI 1245519081
-
dba Sanford POWER Center
- General Acute Care Hospital
- Fargo, ND
- NPI 1528009412
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478476800000",
"number": "1063447605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24760 HOSPITAL DRIVE",
"address_2": "BOX 497",
"city": "RED LAKE",
"state": "MN",
"postal_code": "566710165",
"telephone_number": "218-679-3912",
"fax_number": "218-679-0181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HIGHWAY 1",
"address_2": "IHS BOX 165",
"city": "RED LAKE",
"state": "MN",
"postal_code": "566710165",
"telephone_number": "218-679-3912",
"fax_number": "218-679-0181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORROMEO",
"first_name": "MICHAEL ANTHONY",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-12",
"last_updated": "2016-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MN",
"license": "43108",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS OF MN",
"identifier": "34G20BO",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PART B",
"identifier": "HSZ011",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PART B",
"identifier": "HSZ009",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "510010100",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Red Lake, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.