Vicki Boruta

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA000872-L Issued in PA

Practice address

2701 Blair Mill Rd
Suite 8
Willow Grove, PA 19090-1041

Phone

(215) 957-9250

Fax

(215) 957-9254

NPI assigned

Sep 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Nephrology & Hypertension Associates PC

  • Specialist
  • Langhorne, PA
  • NPI 1417980954
  NPD (past)

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124120126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 BLAIR MILL RD",
            "address_2": "SUITE 8",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901041",
            "telephone_number": "215-957-9250",
            "fax_number": "215-957-9254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 BLAIR MILL RD",
            "address_2": "SUITE 8",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901041",
            "telephone_number": "215-957-9250",
            "fax_number": "215-957-9254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORUTA",
        "first_name": "VICKI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA000872-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Marie Black, OT
• Sherry L Blumenthal, M.D.
• Kevin R Booth, MD
• Leah Rebecca Booze, LPC
• Laura A Borthwick, MD
• Brittany Kathryn Bowden, SLP-CF
• Kathryn Anne Bowry, M.D.
• Randi Boyce
• Elizabeth Braccia-Hubbard, LCSW
• Shyam Brahmabhatt, MD

• Medical Physician Assistant in Willow Grove, PA
• Providers in Willow Grove, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.