Tamara Borukhov

Primary specialty

Home Modifications ContractorTaxonomy code 171WH0202X

License

201562498600SL Issued in CO

Practice address

13057 E Colorado Ave
Aurora, CO 80012-5322

Phone

(720) 297-7542

NPI assigned

Jan 19, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Jack of All Trades LLC Co

  • Home Modifications Contractor
  • Aurora, CO
  • NPI 1447619457
  NPD Authorized official

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

{
    "created_epoch": "1453161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1245697416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13057 E COLORADO AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800125322",
            "telephone_number": "720-297-7542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13057 E COLORADO AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800125322",
            "telephone_number": "720-297-7542"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2383 S Vaughn Way",
            "address_2": "suite 1-101",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800142018",
            "country_code": "US",
            "telephone_number": "720-297-7542",
            "fax_number": "303-745-3393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORUKHOV",
        "first_name": "TAMARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-19",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": "CO",
            "license": "201562498600SL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haleigh Nicole Borneman, NP-C
• Dominika Borowa, PHD
• Mariusz Przemyslaw Borowicz, D.D.S
• Andre Borrego
• Leandra Amber Borrego
• Anthony Bos
• Marianne Bosch
• Sarah Elizabeth Bosch, PA-C
• Skyla Cherise Bosco
• Krystal Kapiolani Bosenbark, RD

• Home Modifications Contractor in Aurora, CO
• Providers in Aurora, CO by specialty
• Home Modifications Contractor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.