Bogdan Borisenko, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA065557 Issued in PA

Practice address

300 State St Ste 301
Erie, PA 16507-1430

Phone

(814) 877-7907

NPI assigned

Jun 7, 2024

Last updated

Dec 11, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: bborisenko429079@upmc.direct-ci.com
• Direct secure messaging: bogdan.p.borisenko@upmcdirect.com

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.

• Children's Community Care

  • Pediatrics Physician
  • Wexford, PA
  • NPI 1659339547
  NPD (past)

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

{
    "created_epoch": "1717718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1265274773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5604 JONES LN",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165051124",
            "telephone_number": "814-923-9715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 STATE ST STE 301",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071430",
            "telephone_number": "814-877-7907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3330 Peach St Ste 106",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165082771",
            "country_code": "US",
            "telephone_number": "814-877-8586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORISENKO",
        "first_name": "BOGDAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-07",
        "last_updated": "2024-12-11",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA065557",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA065557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bogdan.p.borisenko@upmcdirect.com",
            "affiliation": "N",
            "address_1": "600 Grant St Fl 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rachel Bonyai, MSW
• Angela M Bootes, CRNP
• Dennis P Borczon, MD
• Beth A Borecky, LMT, BCTMB,MMMT,CPT
• Angela Trice Borgia, D.M.D.
• Mark A Borland, LPC, PHD
• Eldena Borovina, PA-C
• David T. Borowski, MD
• Katherine Borrelli-Waters, APRN,FNP-BC
• Lindsey Borrero, LBS

• Medical Physician Assistant in Erie, PA
• Providers in Erie, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; 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.