NPIMap

Individual provider Active NPI

Mark D Borchelt, MD, FACE

  • Endocrinology, Diabetes & Metabolism Physician
  • Gulfport, MS
National Provider Identifier
1194776286
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
24066 Issued in MS
Practice address
4540 W Railroad St
Gulfport, MS 39501-2480
Phone
(228) 867-6062
Fax
(228) 867-2598
NPI assigned
May 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X ME62666 FL
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 24066 MS Primary

Addresses

Primary practice location

4540 W Railroad St
Gulfport, MS 39501-2480

Mailing address

PO Box 1810
Gulfport, MS 39502-1810
Phone (228) 867-6062

Other practice location 1

835 Thames Ave
Bay St Louis, MS 39520-5005
Phone (228) 575-2383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151130000718 MS Practitioner - EndocrinologyPractitioner - Internal Medicine 8729158167 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Northeastern Ohio University College of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

1340 Broad Ave
Gulfport, MS 39501-2460

1340 Broad Ave
Gulfport, MS 39501-2465

4540 W Railroad St
Gulfport, MS 39501-2480
Phone (228) 867-6052

Hospital & facility affiliations

  • Memorial Hospital at Gulfport Hospital, Gulfport, MS, CCN 250019
  • Singing River Gulfport Hospital, Gulfport, MS, CCN 250123

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24066MSMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport Current Accepting new patients
The National Diabetes & Obesity Research Institute at Tradition, Missi Endocrinology, Diabetes & Metabolism CurrentSince Nov 7, 2018 Accepting new patients

Locations

19289C Saint Joseph St
Biloxi, MS 39532
Phone (228) 822-6052

Interoperability endpoints

  • Direct secure messaging: mborchelt@direct.mhg.com

Organizations & group practices 3

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.

Hospital & facility affiliations 61

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

View all 61

NPI Registry JSON

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1194776286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1810",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395021810",
            "telephone_number": "228-867-6062",
            "fax_number": "228-575-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 W RAILROAD ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012480",
            "telephone_number": "228-867-6062",
            "fax_number": "228-867-2598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "835 Thames Ave",
            "address_purpose": "LOCATION",
            "city": "Bay St Louis",
            "state": "MS",
            "postal_code": "395205005",
            "country_code": "US",
            "telephone_number": "228-575-2383",
            "fax_number": "228-463-0827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORCHELT",
        "first_name": "MARK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD, FACE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME62666",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MS",
            "license": "24066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.