Individual provider Active NPI

Bryan R Borenitsch, D.C.

  • Chiropractor
  • Kalamazoo, MI
National Provider Identifier
1184962789
Registry record updated May 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301009991 Issued in MI
Practice address
1509 Portage St
Kalamazoo, MI 49001-3803
Phone
(269) 343-2300
NPI assigned
Jan 17, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301009991 MI Primary

Addresses

Primary practice location

1509 Portage St
Kalamazoo, MI 49001-3803

Mailing address

1509 Portage St
Kalamazoo, MI 49001-3803
Phone (269) 343-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150605002113 MI Practitioner - Chiropractic 1850612524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

516 Whites Rd
Kalamazoo, MI 49008-3050
Phone (269) 343-2300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Borenitsch Health Services, LLC Chiropractor CurrentSince Apr 29, 2015 Accepting new patients

Locations

1509 Portage St
Kalamazoo, MI 49001
Phone (269) 343-2300

516 Whites Rd
Kalamazoo, MI 49008
Phone (269) 343-2300

Organizations & group practices 1

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": "1358380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430870400000",
    "number": "1184962789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 PORTAGE ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490013803",
            "telephone_number": "269-343-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 PORTAGE ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490013803",
            "telephone_number": "269-343-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORENITSCH",
        "first_name": "BRYAN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-17",
        "last_updated": "2015-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.