Individual provider Active NPI

Manuel Rafael Bornia, MD

  • Internal Medicine Physician
  • Atlantis, FL
National Provider Identifier
1073571063
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME47911 Issued in FL
Practice address
180 JFK Dr Ste 260
Atlantis, FL 33462-6642
Phone
(561) 439-4480
Fax
(561) 641-6626
NPI assigned
May 2, 2006
Last updated
Oct 17, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME47911 FL
Internal Medicine Physician 207R00000X ME47911 FL Primary

Addresses

Primary practice location

180 JFK Dr Ste 260
Atlantis, FL 33462-6642

Mailing address

180 JFK Dr Ste 260
Atlantis, FL 33462-6642
Phone (561) 439-4480

Other identifiers 1

IdentifierTypeStateIssuer
024429200MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Medpoint

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050125000970 FL Practitioner - Family PracticePractitioner - Internal Medicine 1355391525 Reassigns benefits to 1 organization
Practice locations: Atlantis, FL

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Internal Medicine
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

180 JFK Dr
Suite 260
Atlantis, FL 33462

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Imaging, LLC CurrentSince Mar 7, 2015 Accepting new patients
Independent Imaging LLC CurrentSince Mar 7, 2015 Accepting new patients
Palm Springs Internal Medicine Specialist Current Accepting new patients
Palms West Imaging Inc Past Accepting new patients
Palms West MRI, LLC Past Accepting new patients

Locations

701 S Main St
Belle Glade, FL 33430
Phone (561) 795-5558

5053 S Congress Ave
Ste 202
Lake Worth, FL 33461
Phone (561) 439-4480

3347 S State Road 7
Ste 100
Wellington, FL 33449
Phone (561) 795-5558

Organizations & group practices 5

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1073571063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 JFK DR STE 260",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334626642",
            "telephone_number": "561-439-4480",
            "fax_number": "561-641-6626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 JFK DR STE 260",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334626642",
            "telephone_number": "561-439-4480",
            "fax_number": "561-641-6626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORNIA",
        "first_name": "MANUEL",
        "middle_name": "RAFAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME47911",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME47911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024429200",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Medpoint",
            "affiliation": "N",
            "address_1": "180 JFK Dr Ste 260",
            "city": "Atlantis",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334626642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlantis, FL

Sources for this page

Verify at the official NPI Registry.