NPIMap

Individual provider Active NPI

Lance Hamilton Borup, D.O.

  • Diagnostic Radiology Physician
  • Branson, MO
National Provider Identifier
1356320436
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2009018431 Issued in MO
Practice address
525 Branson Landing Blvd
Branson, MO 65616-2052
Phone
(417) 875-3000
NPI assigned
Jan 17, 2006
Last updated
Feb 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 0533791 KS
Diagnostic Radiology Physician 2085R0202X 4587 OK
Diagnostic Radiology Physician 2085R0202X E-8860 AR
Diagnostic Radiology Physician 2085R0202X 2009018431 MO Primary

Addresses

Primary practice location

525 Branson Landing Blvd
Branson, MO 65616-2052

Mailing address

1202 Rustic RDG
Joplin, MO 64804-3679
Phone (417) 434-2991

Other identifiers 4

IdentifierTypeStateIssuer
200202290AMedicaidOK
200614030DMedicaidKS
204512701MedicaidMO
1356320436MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20090820000501 MO Practitioner - Diagnostic Radiology 4789682956 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lester E Cox Medical CentersGroup PAC ID 8628092897, 243 clinicians

Practice addresses (Care Compare)

1001 E Primrose
Springfield, MO 65807-5155

1001 E Primrose St
Springfield, MO 65807-5155

525 Branson Landing Blvd
Branson, MO 65616-2052

525 Branson Landing Blvd
Suite 508
Branson, MO 65616-2131
Phone (417) 335-7540

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.53 of 100Reported as group
Quality
96.63
Promoting interoperability
100
Improvement activities
40
Cost
81.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4587OKMDGeneral Practice Dentistry
E-8860ARMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Skaggs Community Hospital Association CurrentSince Apr 1, 2026 Accepting new patients
Skaggs Community Hospital Association Diagnostic Radiology CurrentSince Apr 1, 2026 Accepting new patients
Lester E Cox Medical Centers CurrentSince Jan 30, 2023 Accepting new patients
Sjmgroup Past Accepting new patients
St Johns Regional Medical Center Past Accepting new patients
St Johns Regional Medical Center Past Accepting new patients

Locations

3125 Dr Russell Smith Way
Carthage, MO 64836
Phone (417) 358-8121

1001 E Primrose St
Springfield, MO 65807
Phone (417) 875-3434

Organizations & group practices 7

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.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1356320436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 RUSTIC RDG",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043679",
            "telephone_number": "417-434-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 BRANSON LANDING BLVD",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656162052",
            "telephone_number": "417-875-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORUP",
        "first_name": "LANCE",
        "middle_name": "HAMILTON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KS",
            "license": "0533791",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OK",
            "license": "4587",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AR",
            "license": "E-8860",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2009018431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200202290A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200614030D",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204512701",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356320436",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Branson, MO

Sources for this page

Verify at the official NPI Registry.