Individual provider Active NPI

Daniel Borisov, PA

  • Physician Assistant
  • Sacramento, CA
National Provider Identifier
1265395230
Registry record updated Dec 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5656 Verner Oak CT Unit 40
Sacramento, CA 95841-2066
Phone
(509) 230-2704
NPI assigned
Dec 6, 2025
Last updated
Dec 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CA Primary

Addresses

Primary practice location

5656 Verner Oak CT Unit 40
Sacramento, CA 95841-2066

Mailing address

5656 Verner Oak CT Unit 40
Sacramento, CA 95841-2066
Phone (509) 230-2704

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260304001710 CA Practitioner - Physician Assistant 1153803630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthy Living Primary Care IncGroup PAC ID 7618062225, 20 clinicians

Practice addresses (Care Compare)

82 Clarksville Rd
Suite 120
Folsom, CA 95630-8210
Phone (916) 983-8868

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
67685CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Living Primary Care, Inc CurrentSince Feb 23, 2026 Accepting new patients

Locations

11634 Fair Oaks Blvd
Fair Oaks, CA 95628
Phone (916) 852-6001

82 Clarksville Rd
Ste 120
Folsom, CA 95630
Phone (916) 413-1306

Organizations & group practices 1

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": "1764979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764979200000",
    "number": "1265395230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5656 VERNER OAK CT UNIT 40",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958412066",
            "telephone_number": "509-230-2704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5656 VERNER OAK CT UNIT 40",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958412066",
            "telephone_number": "509-230-2704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORISOV",
        "first_name": "DANIEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-12-06",
        "last_updated": "2025-12-06",
        "certification_date": "2025-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.