Individual provider Active NPI

Bruce Alan Bornfleth, M.D.

  • Internal Medicine Physician
  • Palm Springs, CA
National Provider Identifier
1083607667
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A88125 Issued in CA
Practice address
151 S Sunrise Way
Suite 100
Palm Springs, CA 92262-0118
Phone
(760) 969-7770
Fax
(760) 969-7771
NPI assigned
Aug 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A88125 CA Primary

Addresses

Primary practice location

151 S Sunrise Way
Suite 100
Palm Springs, CA 92262-0118

Mailing address

151 S Sunrise Way
Suite 100
Palm Springs, CA 92262-0118
Phone (760) 969-7770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20110106000860 CA Practitioner - Internal Medicine 3173712114 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
88125CAMDClinical Social Worker
A88125CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Athena Medical Group of the Central Coast, Inc. CurrentSince Apr 25, 2022 Accepting new patients

Locations

335 Katherine Ave
Ste 1
Salinas, CA 93901
Phone (831) 751-6222

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1083607667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 S SUNRISE WAY",
            "address_2": "SUITE 100",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922620118",
            "telephone_number": "760-969-7770",
            "fax_number": "760-969-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 S SUNRISE WAY",
            "address_2": "SUITE 100",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922620118",
            "telephone_number": "760-969-7770",
            "fax_number": "760-969-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORNFLETH",
        "first_name": "BRUCE",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-29",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A88125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

Verify at the official NPI Registry.