Bruce Glenn Borkosky, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY5159 Issued in FL

Practice address

1800 Lakeview Dr
Sebring, FL 33870-7928

Phone

(304) 837-2782

Fax

(813) 200-8450

NPI assigned

Jul 3, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Bruce Borkosky PSYD PA

  • Psychologist
  • Sebring, FL
  • NPI 1396130241
  NPD (past) Authorized official
• GPS II

  • Health Service Psychologist
  • Longboat Key, FL
  • NPI 1861740888
  NPD (past)
• John P McDonough III

  • Psychologist
  • Tampa, FL
  • NPI 1346280161
  NPD (past)

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282089600000",
    "number": "1164620969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 LAKEVIEW DR",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338707928",
            "telephone_number": "304-837-2782",
            "fax_number": "813-200-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 LAKEVIEW DR",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338707928",
            "telephone_number": "304-837-2782",
            "fax_number": "813-200-8450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORKOSKY",
        "first_name": "BRUCE",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2010-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY5159",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "FL",
            "license": "PY5159",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "FL",
            "license": "PY5159",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Sebring, FL
• Providers in Sebring, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.