NPIMap

Individual provider Active NPI

Tayyebeh Nahid Borogerdi, FNP

  • Family Nurse Practitioner
  • Vestal, NY
National Provider Identifier
1346598950
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
337552 Issued in NY
Practice address
3101 Shippers Rd
Vestal, NY 13850-2080
Phone
(607) 786-4822
Fax
(607) 251-2010
NPI assigned
Aug 29, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 0337552 NY
Family Nurse Practitioner 363LF0000X 337552 NY Primary

Addresses

Primary practice location

3101 Shippers Rd
Vestal, NY 13850-2080

Mailing address

105 Ridgehaven Drive
Vestal, NY 13850
Phone (607) 786-4822

Other practice location 1

105 Ridgehaven Drive
Vestal, NY 13850
Phone (607) 786-4822

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tayyebeh.borogerdi@direct.lourdes.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20130618000286 NY Practitioner - Nurse Practitioner 4789823089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Our Lady of Lourdes Memorial Hospital Inc 249 clinicians

Practice addresses (Care Compare)

3101 Shippers Rd
Suite 203
Vestal, NY 13850-2082
Phone (607) 786-4822

Hospital & facility affiliations

  • Our Lady of Lourdes Memorial Hospital, Inc Hospital, Binghamton, NY, CCN 330011
  • United Health Services Hospitals, Inc Hospital, Binghamton, NY, CCN 330394

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
337552NYMDFamily Nurse Practitioner
0337552NYMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Tier Medical Care - Ny PC CurrentSince Apr 1, 2022 Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince Feb 20, 2013 Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince Feb 20, 2013 Accepting new patients
Our Lady of Lourdes Memorial Hospital Inc. Current Accepting new patients
Twin Tier Pathology Associates, PC Current Accepting new patients

Locations

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

169 Riverside Dr
Ste 206
Binghamton, NY 13905
Phone (607) 798-6701

500 5th Ave
Owego, NY 13827
Phone (607) 687-1122

105 Ridgehaven Dr
Vestal, NY 13850
Phone (607) 786-4822

3101 Shippers Rd
Ste 203
Vestal, NY 13850
Phone (607) 786-4822

3101 Shippers Rd
Vestal, NY 13850
Phone (607) 250-2180

Interoperability endpoints

  • Direct secure messaging: tborogerdi196734@direct-guthrie.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 2

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": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1346598950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 RIDGEHAVEN DRIVE",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "13850",
            "telephone_number": "607-786-4822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 SHIPPERS RD",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138502080",
            "telephone_number": "607-786-4822",
            "fax_number": "607-251-2010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Ridgehaven Drive",
            "address_purpose": "LOCATION",
            "city": "Vestal",
            "state": "NY",
            "postal_code": "13850",
            "country_code": "US",
            "telephone_number": "607-786-4822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOROGERDI",
        "first_name": "TAYYEBEH",
        "middle_name": "NAHID",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-29",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NY",
            "license": "0337552",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "337552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tayyebeh.borogerdi@direct.lourdes.com",
            "affiliation": "N",
            "endpointDescription": "Lourdes Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "3101 Shippers Rd",
            "city": "Vestal",
            "state": "NY",
            "country_code": "US",
            "postal_code": "138502080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vestal, NY

Sources for this page

Verify at the official NPI Registry.