Individual provider Active NPI

Albert Joseph Borelli Jr., MD

  • Diagnostic Radiology Physician
  • Bluffton, SC
National Provider Identifier
1265554570
Registry record updated Jan 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
20797 Issued in SC
Practice address
18 Clarks Summit Drive
Bluffton, SC 29910
Phone
(843) 815-9700
Fax
(843) 815-9701
NPI assigned
Apr 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 20797 SC
Diagnostic Radiology Physician 2085R0202X 20797 SC Primary

Addresses

Primary practice location

18 Clarks Summit Drive
Bluffton, SC 29910

Mailing address

PO Box 75513
Charlotte, NC 28275-0513
Phone (843) 815-9700

Other identifiers 2

IdentifierTypeStateIssuer
PL0067MedicaidSC
300133498OtherSCRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060307000730 SC Practitioner - Diagnostic Radiology 3375550924 Practice locations: Bluffton, SC

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20797SCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MRI at Belfair LLC CurrentSince Apr 22, 2002 Accepting new patients
Savannah Radiologists, PA Diagnostic Radiology Past Accepting new patients
Cambria Somerset Radiology & Nuclear Medicine Group, Inc. Diagnostic Radiology Past Accepting new patients
Diagnostic Health Center of Hilton Head LLC Past Accepting new patients
Radiology Professional Services, LLC Diagnostic Radiology Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

18 Clark Summit Dr
Bluffton, SC 29910
Phone (843) 815-9700

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643500800000",
    "number": "1265554570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 75513",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282750513",
            "telephone_number": "843-815-9700",
            "fax_number": "843-815-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 CLARKS SUMMIT DRIVE",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "29910",
            "telephone_number": "843-815-9700",
            "fax_number": "843-815-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORELLI",
        "first_name": "ALBERT",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2022-01-30",
        "certification_date": "2022-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SC",
            "license": "20797",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "20797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PL0067",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300133498",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluffton, SC

Sources for this page

Verify at the official NPI Registry.