Individual provider Active NPI

Adam D. Borecky, MD

  • Psychiatry Physician
  • Ladera Ranch, CA
National Provider Identifier
1194389452
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A178050 Issued in CA
Practice address
333 Corporate Dr Ste 260
Ladera Ranch, CA 92694-2180
Phone
(949) 768-2988
Fax
(949) 768-2980
NPI assigned
Apr 23, 2019
Last updated
Jun 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A178050 CA Primary

Addresses

Primary practice location

333 Corporate Dr Ste 260
Ladera Ranch, CA 92694-2180

Mailing address

2807 Lake Michigan Dr NW # 3
Grand Rapids, MI 49504-5831
Phone (909) 255-1753

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MI2 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

Enrollment IDStateProvider typePAC IDDetails
I20220628001973 CA Practitioner - Psychiatry 2860871415 Reassigns benefits to 1 organization
I20250930000877 MI Practitioner - Psychiatry 2860871415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Loma Linda University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

555 Midtowne St NE
Suite 304
Grand Rapids, MI 49503-5731
Phone (616) 458-4444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A178050CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Borecky Health Inc. Psychiatry CurrentSince Jun 4, 2023 Accepting new patients
Opus Health PLLC Psychiatry CurrentSince Jul 26, 2025 Accepting new patients
Kevin Kinback Psychiatry Past Accepting new patients

Locations

1276 Auto Park Way
Ste D
Escondido, CA 92029

333 Corporate Dr
Ste 260
Ladera Ranch, CA 92694
Phone (949) 456-4265

2807 Lake Michigan Dr NW
#3
Grand Rapids, MI 49504

555 Midtowne St NE
Ste 304
Grand Rapids, MI 49503
Phone (616) 458-4444

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: aborecky94347@direct.llu.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1194389452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2807 LAKE MICHIGAN DR NW # 3",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495045831",
            "telephone_number": "909-255-1753",
            "fax_number": "760-227-5720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 CORPORATE DR STE 260",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926942180",
            "telephone_number": "949-768-2988",
            "fax_number": "949-768-2980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORECKY",
        "first_name": "ADAM",
        "middle_name": "D.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-23",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A178050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ladera Ranch, CA

Sources for this page

Verify at the official NPI Registry.