Individual provider Active NPI

Paul A Bormes, MD

  • Anesthesiology Physician
  • Rapid City, SD
National Provider Identifier
1083675730
Registry record updated Jan 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
3420 Issued in SD
Practice address
350 Fairmont Blvd
Rapid City, SD 57701-5423
Phone
(605) 394-7010
NPI assigned
Mar 31, 2006
Last updated
Jan 23, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 3420 SD Primary

Addresses

Primary practice location

350 Fairmont Blvd
Rapid City, SD 57701-5423

Mailing address

PO Box 7025
Amagansett, NY 11930-7025
Phone (888) 877-3850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20080421000187 SD Practitioner - Anesthesiology 5395823132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Sanford School of Medicine of University of South Dakota, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera St LukesGroup PAC ID 6406764927, 164 clinicians

Practice addresses (Care Compare)

305 S State St
Aberdeen, SD 57401-4527
Phone (605) 622-5100

8 E US Hwy 12
Groton, SD 57445-2176
Phone (605) 397-4242

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Avera St. Luke's Current Accepting new patients
Avera St. Lukes CurrentSince Aug 1, 2019 Accepting new patients
Avera St. Luke's CurrentSince Aug 1, 2019 Accepting new patients
West River Anesthesiology Consultants PC Anesthesiology Past Accepting new patients

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 4

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327276800000",
    "number": "1083675730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7025",
            "city": "AMAGANSETT",
            "state": "NY",
            "postal_code": "119307025",
            "telephone_number": "888-877-3850",
            "fax_number": "631-329-6951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 FAIRMONT BLVD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577015423",
            "telephone_number": "605-394-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORMES",
        "first_name": "PAUL",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2012-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SD",
            "license": "3420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.