Mitchell Ira Boriskin, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

85073033N1 Issued in OR

Practice address

48134 Highway 58
Oakridge, OR 97463-9601

Phone

(541) 640-7625

NPI assigned

Oct 23, 2006

Last updated

Jan 23, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Icco, LLC

  dba BestMed

  • Urgent Care Clinic/Center
  • Eugene, OR
  • NPI 1407004757
  Medicare reassignment NPD
• Icco LLC

  dba BestMed

  • Rural Health Clinic/Center
  • Florence, OR
  • NPI 1740896547
  NPD
• Icco, LLC

  dba Eugene Urgent Care-Coburg

  • Urgent Care Clinic/Center
  • Eugene, OR
  • NPI 1902131022
  NPD

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1376626655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1292 HIGH ST STE 224",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013238",
            "telephone_number": "541-500-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48134 HIGHWAY 58",
            "city": "OAKRIDGE",
            "state": "OR",
            "postal_code": "974639601",
            "telephone_number": "541-640-7625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORISKIN",
        "first_name": "MITCHELL",
        "middle_name": "IRA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "85073033N1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175281",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Morgan Scott Barber, M.S.W.
• Jodi A Budd, R.D.H, L.A.P
• City of Oakridge
• Jeryl M Cossette, LMT
• Jessica Leigh Couey, LPC
• Tolulope Dada, APRN

• Nurse Practitioner in Oakridge, OR
• Providers in Oakridge, OR by specialty
• Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.