Individual provider Active NPI

Nicholas D. Borchers, PA-C

  • Physician Assistant
  • Wheaton, IL
National Provider Identifier
1093141251
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085004816 Issued in IL
Practice address
199 Town SQ Ste a
Wheaton, IL 60189-3878
Phone
(630) 871-6690
Fax
(630) 547-5019
NPI assigned
Sep 19, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085004816 IL Primary

Addresses

Primary practice location

199 Town SQ Ste a
Wheaton, IL 60189-3878

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other practice location 1

10719 160th St
Orland Park, IL 60467-5541
Phone (708) 226-4512

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nborchers268144@dulyhealthandcare.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131210000332 IL Practitioner - Physician Assistant 4385871755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10 S449 Carrington Cir
Willowbrook, IL 60527-6945

PO Box
Chicago, IL 60677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085004816ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince May 6, 2024 Accepting new patients
Dupage Medical Group LTD CurrentSince May 6, 2024 Accepting new patients
Dermatology Associates LTD PastSince Aug 23, 2020 Accepting new patients
Physicians Dermpath Laboratory Past Accepting new patients

Locations

199 Town Sq
Ste A
Wheaton, IL 60189
Phone (630) 871-6690

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ACEFAA
  • Direct secure messaging: nborchers268144@dulyhealthandcare.direct-ci.com
  • Direct secure messaging: nborchers@directaddress.net

Organizations & group practices 4

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": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1093141251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 TOWN SQ STE A",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601893878",
            "telephone_number": "630-871-6690",
            "fax_number": "630-547-5019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10719 160th St",
            "address_purpose": "LOCATION",
            "city": "Orland Park",
            "state": "IL",
            "postal_code": "604675541",
            "country_code": "US",
            "telephone_number": "708-226-4512",
            "fax_number": "708-226-1497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORCHERS",
        "first_name": "NICHOLAS",
        "middle_name": "D.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-19",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nborchers268144@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "199 Town Sq Ste A",
            "city": "Wheaton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601893878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.