Eftu Omer Boru, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

67712 Issued in MN

Practice address

11269 Jefferson Hwy N
Champlin, MN 55316-3123

Phone

(763) 236-0600

Fax

(763) 427-0790

NPI assigned

Mar 29, 2017

Last updated

Oct 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in WI, MN2 enrollments

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 2

Specialty

Family Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Hospital, Coon Rapids, MN, CCN 240115

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eboru188071@direct.myadvocateaurora.org

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.

• Allina Health System

  dba Allina Health Annandale Clinic

  • Family Medicine Physician
  • Annandale, MN
  • NPI 1457657249
  Medicare reassignment Care Compare group NPD
• Twin Cities Physicians Professional Corporation

  • Multi-Specialty Clinic/Center
  • Golden Valley, MN
  • NPI 1992176499
  Medicare reassignment NPD
• Allina Health System

  dba Twin Cities Spine Center

  • Internal Medicine Physician
  • Minneapolis, MN
  • NPI 1669871455
  NPD
• Allina Health System

  dba Allina Health TeleRheumatology

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Allina Health System

  dba Allina Health Addiction and Psychotherapy-Mercy Hospital-Unity Campus

  • Addiction (Substance Use Disorder) Psychologist
  • Fridley, MN
  • NPI 1083197214

  Hospital

  Care Compare affiliation
• NPI 1215755400

  • NPI 1215755400

  Hospital

  Care Compare affiliation
• Allina Health System

  dba Allina Health Inpatient Addiction Treatment -Mercy Hospital -Unity Campus

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Fridley, MN
  • NPI 1285692145
  Care Compare affiliation
• Allina Health System

  dba Mercy Hospital

  • General Acute Care Hospital
  • Coon Rapids, MN
  • NPI 1316904287
  Care Compare affiliation
• NPI 1417548959

  • NPI 1417548959

  Hospital

  Care Compare affiliation
• Allina Health System

  dba Minnesota Perinatal Physicians - Mercy

  • Maternal & Fetal Medicine Physician
  • Coon Rapids, MN
  • NPI 1447527767

  Hospital

  Care Compare affiliation
• Allina Health System

  dba Allina Health Mental Health - Mercy Hospital, Unity Campus

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fridley, MN
  • NPI 1598700528

  Hospital

  Care Compare affiliation
• Allina Health System

  dba Mercy Hospital

  • Psychiatric Hospital Unit
  • Fridley, MN
  • NPI 1609056100
  Care Compare affiliation

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1174055131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11269 JEFFERSON HWY N",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553163123",
            "telephone_number": "763-236-0600",
            "fax_number": "763-427-0790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6611 Spring St",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "WI",
            "postal_code": "534062632",
            "country_code": "US",
            "telephone_number": "262-504-3100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORU",
        "first_name": "EFTU",
        "middle_name": "OMER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-29",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "67712",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "71392",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100092837",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eboru188071@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6611 Spring St",
            "city": "Mount Pleasant",
            "state": "WI",
            "country_code": "US",
            "postal_code": "534062632",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "6611 Spring St",
            "city": "Mount Pleasant",
            "state": "WI",
            "country_code": "US",
            "postal_code": "534062632",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eboru671734@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "11269 Jefferson Hwy N",
            "city": "Champlin",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553163123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bio-Medical Applications of Minnesota, Inc. (Fresenius Medical Care of Champlin)
• Alexander W Blidi, DOCTOR OF HEALTH INF
• Ashley A Bliss, P.A.
• Morgan Bobo
• Matthew L Boelter, HCP
• Faisale Sale Boukari, RN
• Brist Chiropractic & Naturopathic Wellness Center LLC
• Jeff Brist, D.C.
• Megan Brodhag, DPT
• Arthur Thomas Bryant Jr., LICSW

• Family Medicine Physician in Champlin, MN
• Providers in Champlin, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.