Active NPI
Kelly Borgman, O.D.
- Pediatric Optometrist
- Holland, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Optometrist
- License
- 4901005784
- Practice address
- 904 Washington Ave Ste 120
Holland, MI 49423-7724 - Phone
- (616) 796-9995
- NPI assigned
- Jan 16, 2013
- Last updated
- Aug 20, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
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 100
- Quality
- 93.82
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 78.84
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eye Associates of Southern Indiana PC | Optometrist | Current | Accepting new patients |
| Eyes to See Pediatric Ophthalmology PLLC | Current | Accepting new patients | |
| West Point Optical Group | Optometrist | Current | Accepting new patients |
| Eye Associates of Southern Indiana PC | Optometrist | Current | Accepting new patients |
| Eye Care for Kids, LTD | Pediatrics | Past | 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 | Past | 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
- 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.
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- Optometrist
- Novi, MI
- NPI 1831548890
-
- Ophthalmology Physician
- Zeeland, MI
- NPI 1497086334
-
- Ophthalmology Physician
- Jeffersonville, IN
- NPI 1336219922
Optometrist
-
dba Frankfort Vision Center
- Optometrist
- Frankfort, KY
- NPI 1962533851
-
- Optometrist
- Ann Arbor, MI
- NPI 1073983698
-
- Optometrist
- Grandville, MI
- NPI 1598135113
-
- Optometrist
- Rochester Hills, MI
- NPI 1770953390
-
- Durable Medical Equipment & Medical Supplies
- New Albany, IN
- NPI 1083607592
Optometrist
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; 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.