Individual provider Active NPI

Kelly Borgman, O.D.

  • Pediatric Optometrist
  • Holland, MI
National Provider Identifier
1063759678
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric OptometristTaxonomy code 152WP0200X
License
4901005784 Issued in MI
Practice address
904 Washington Ave Ste 120
Holland, MI 49423-7724
Phone
(616) 796-9995
NPI assigned
Jan 16, 2013
Last updated
Aug 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1910DT KY
Pediatric Optometrist 152WP0200X 1910DT KY
Pediatric Optometrist 152WP0200X 4901005784 MI Primary

Addresses

Primary practice location

904 Washington Ave Ste 120
Holland, MI 49423-7724

Mailing address

904 Washington Ave Ste 120
Holland, MI 49423-7724
Phone (616) 796-9995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250812000291 MI Practitioner - Optometry 8022353499 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Point Optical GroupGroup PAC ID 9032491246, 28 clinicians

Practice addresses (Care Compare)

3343 Century Ctr St SW
Grandville, MI 49418-3109
Phone (616) 249-7362

Merit-based Incentive Payment System (MIPS)

Final score
91.8 of 100Reported as group
Quality
93.82
Promoting interoperability
100
Improvement activities
40
Cost
78.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Associates of Southern Indiana PC Optometrist CurrentSince Jul 1, 2023 Accepting new patients
Eyes to See Pediatric Ophthalmology PLLC CurrentSince Sep 1, 2025 Accepting new patients
West Point Optical Group Optometrist CurrentSince Dec 16, 2025 Accepting new patients
Eye Associates of Southern Indiana PC Optometrist CurrentSince Jul 1, 2023 Accepting new patients
Eye Care for Kids, LTD Pediatrics PastSince Oct 1, 2018 Accepting new patients
West Point Optical Group Optometrist Past Accepting new patients
Eye Associates of Southern Indiana PC Optometrist Past Accepting new patients
West Point Optical Group Optometrist PastSince Dec 16, 2025 Accepting new patients
West Point Optical Group Optometrist Past Accepting new patients

Locations

302 W 14th St
#100A
Jeffersonvlle, IN 47130

302 W 14th St
Ste 100A
Jeffersonvlle, IN 47130
Phone (812) 590-6157

1102 Lyndon Ln
Ste A
Louisville, KY 40222
Phone (502) 426-0307

3343 Century Center St SW
Grandville, MI 49418
Phone (616) 249-7362

904 Washington Ave
Ste 120
Holland, MI 49423
Phone (616) 392-3824

1736 W Michigan Ave
Jackson, MI 49202
Phone (517) 789-7131

575 N Drake Rd
Kalamazoo, MI 49009
Phone (269) 382-5942

2974 28th St SE
Ste A
Kentwood, MI 49512
Phone (616) 949-2120

6650 S Westnedge Ave
Ste 232
Portage, MI 49024
Phone (269) 327-2881

2875 S Rochester Rd
Rochester Hills, MI 48307
Phone (248) 852-5230

4310 Leonard St NW
Ste 103
Walker, MI 49534
Phone (616) 453-0600

8333 Felch St
Zeeland, MI 49464
Phone (616) 741-3790

Interoperability endpoints

  • Direct secure messaging: kelly.borgmanod.p1@direct.have2020.nextgenshare.com

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1358294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1063759678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 WASHINGTON AVE STE 120",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237724",
            "telephone_number": "616-796-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 WASHINGTON AVE STE 120",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237724",
            "telephone_number": "616-796-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORGMAN",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-16",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1910DT",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "KY",
            "license": "1910DT",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "MI",
            "license": "4901005784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.