NPIMap

Individual provider Active NPI

Alwin Borgmann, D.O.

  • Family Medicine Physician
  • La Pine, OR
National Provider Identifier
1073920880
Registry record updated Apr 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OL60566366 Issued in WA
Practice address
51781 Huntington Rd
La Pine, OR 97739-1118
Phone
(541) 907-7040
Fax
(541) 907-7059
NPI assigned
Jul 14, 2014
Last updated
Apr 17, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X OL60566366 WA Primary

Addresses

Primary practice location

51781 Huntington Rd
La Pine, OR 97739-1118

Mailing address

900 S Auburn St Ste a
PO Box 6128
Kennewick, WA 99336-5621

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aborgmann82451@secure.stcharleshealthcare.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180829004388 OR Practitioner - Family Practice 6204126188 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Charles Health System IncGroup PAC ID 8729111513, 379 clinicians

Practice addresses (Care Compare)

211 NW Larch Ave
Family Care
Redmond, OR 97756-1357
Phone (541) 548-2164

51781 Huntington Rd
La Pine, OR 97739-1118
Phone (541) 666-7920

630 N Arrowleaf TRL
Family Care
Sisters, OR 97759-2610
Phone (541) 549-1318

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OL60566366WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Charles Health System, Inc. Family Medicine CurrentSince Aug 27, 2018 Accepting new patients
St. Charles Health System, Inc. CurrentSince Aug 27, 2018 Accepting new patients
St. Charles Health System, Inc. CurrentSince Aug 27, 2018 Accepting new patients
St. Charles Health System, Inc. CurrentSince Aug 27, 2018 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

29358 Network Pl
Chicago, IL 60673

2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333

51781 Huntington Rd
La Pine, OR 97739
Phone (541) 666-7920

1253 NW Canal Blvd
Redmond, OR 97756
Phone (541) 548-8131

211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587081600000",
    "number": "1073920880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S AUBURN ST STE A",
            "address_2": "PO BOX 6128",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993365621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51781 HUNTINGTON RD",
            "city": "LA PINE",
            "state": "OR",
            "postal_code": "977391118",
            "telephone_number": "541-907-7040",
            "fax_number": "541-907-7059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORGMANN",
        "first_name": "ALWIN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-14",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OL60566366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aborgmann82451@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "51781 Huntington Rd",
            "city": "LA Pine",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977391118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in La Pine, OR

Sources for this page

Verify at the official NPI Registry.