Vicky K Borck, D.O.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

20A11284 Issued in CA

Practice address

7850 Vista Hill Ave
San Diego, CA 92123-2717

Phone

(619) 294-4119

Fax

(619) 295-5044

NPI assigned

Oct 2, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

University of North Texas HSC, College of Osteopathic Med, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Emergency and Acute Care Medical Corporation

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1437103942
  Medicare reassignment NPD

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484179200000",
    "number": "1306939038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 S SIERRA AVE",
            "address_2": "UNIT 2",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920751815",
            "telephone_number": "161-929-4411",
            "fax_number": "161-929-5504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7850 VISTA HILL AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232717",
            "telephone_number": "619-294-4119",
            "fax_number": "619-295-5044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORCK",
        "first_name": "VICKY",
        "middle_name": "K",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2017-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A11284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "20A11284",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127427605",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Bor
• Amruti Borad, D.O.
• Allison Borch
• Alexandra Faith Borchard
• Eric Borchert
• Amanda Bordagaray
• Mariana E Bordas, LMFT
• Erlene Kay Borden, M.A.
• Adrienne Borders, PHD
• Michael D Borders, P.T.

• Psychiatry Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.