NPIMap

Individual provider Active NPI

Samantha Anne Borisuk, DO

  • Family Medicine Physician
  • Avon Lake, OH
National Provider Identifier
1245813328
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34.016999 Issued in OH
Practice address
32730 Walker Rd Ste H
Avon Lake, OH 44012-2235
Phone
(440) 930-4955
NPI assigned
May 5, 2021
Last updated
Aug 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34.016999 OH Primary

Addresses

Primary practice location

32730 Walker Rd Ste H
Avon Lake, OH 44012-2235

Mailing address

32730 Walker Rd Ste H
Avon Lake, OH 44012-2235
Phone (440) 930-4955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240812000454 OH Practitioner - Family Practice 7517360696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

158 W Main Rd
Conneaut, OH 44030-2039

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.15 of 100Reported as apm
Quality
82.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc Current Accepting new patients
University Primary Care Practices Inc Family Medicine CurrentSince Aug 1, 2024 Accepting new patients
University Primary Care Practices Inc CurrentSince Aug 1, 2024 Accepting new patients
University Primary Care Practices Past Accepting new patients
University Hospitals Medical Group Inc Past Accepting new patients

Locations

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

29000 Center Ridge Rd
Westlake, OH 44145
Phone (440) 414-6046

Interoperability endpoints

  • Direct secure messaging: sborisuk38778@ehrdirect.uhhospitals.org

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1245813328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32730 WALKER RD STE H",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440122235",
            "telephone_number": "440-930-4955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32730 WALKER RD STE H",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440122235",
            "telephone_number": "440-930-4955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORISUK",
        "first_name": "SAMANTHA",
        "middle_name": "ANNE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-05",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.016999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon Lake, OH

Sources for this page

Verify at the official NPI Registry.