Aaron Paul Borengasser, PA-C
Individual provider Active NPI Physician Assistant · Fayetteville, AR
NPI 1376776047 · NPPES record last updated Sep 16, 2019
Key facts
- NPI
- 1376776047
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA-390 (AR)
- Practice address
- 1100 N College Ave
Fayetteville, AR 72703-1944 - Phone
- (479) 443-4301
- NPI assigned
- Aug 28, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100506000986 | AR | Practitioner - Physician Assistant | 9032247358 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arkansas Central Primary Care, PLLC | Current |
Accepting new patients | |
| Physicians Network Inc Dba Cabot Medical Clinic | Past | Accepting new patients |
Locations
2037 W Main St
Cabot, AR 72023
Phone (501) 843-4555
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA-390 | AR | |
| Physician Assistant | 363A00000X | PA-390 | AR | Yes |
Addresses
Primary practice location
1100 N College Ave
Fayetteville, AR 72703-1944
Mailing address
505 W Pershing Blvd Ste C
North Little Rock, AR 72114-2157
Phone (800) 441-3667
Other providers in Fayetteville, AR
- Ashley Book
- Michael David Booker
- Jamie M Boone
- Dawn Booth
- Lynn Boothe
- Megan I Borter
- Kristin Bosc
- Camille E Boswell
- Aaryn Alexa Boudreaux
- Shelby L Bourne
All providers in Fayetteville, AR · Physician Assistant in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.