Individual provider Active NPI

Sanders H Borisoff, D.D.S.

  • Prosthodontics
  • New York, NY
National Provider Identifier
1366642324
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
029682 Issued in NY
Practice address
20 E 68TH St
Suite 210
New York, NY 10065-5844
Phone
(212) 861-2170
NPI assigned
Jul 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 029682 NY Primary

Addresses

Primary practice location

20 E 68TH St
Suite 210
New York, NY 10065-5844

Mailing address

20 E 68TH St
Suite 210
New York, NY 10065-5844
Phone (212) 861-2170

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150622001538 NJ Order and Referring Only - DentistPractitioner - Dentist 4385955038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
029682NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Park East Dental Associates Prosthodontics Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1366642324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 E 68TH ST",
            "address_2": "SUITE 210",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100655844",
            "telephone_number": "212-861-2170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 E 68TH ST",
            "address_2": "SUITE 210",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100655844",
            "telephone_number": "212-861-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORISOFF",
        "first_name": "SANDERS",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-18",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NY",
            "license": "029682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.