Ethan Israel Bortniker, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

A155188 Issued in CA

Practice address

200 W Arbor Dr
San Diego, CA 92103-9000

Phone

(800) 926-8273

NPI assigned

Jun 11, 2008

Last updated

Jan 30, 2019By 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 CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Gastroenterology

Education

Boston University School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Genesis Healthcare Partners PCGroup PAC ID 2163606807, 232 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Scripps Memorial Hospital - Encinitas Hospital, Encinitas, CA, CCN 050503

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: ethan.bortniker.1@3663.direct.athenahealth.com

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.

• Genesis Healthcare Partners PC

  • Specialist
  • Encinitas, CA
  • NPI 1548567498
  Medicare reassignment Care Compare group NPD
• Eisenhower Medical Center

  dba Eisenhower Health

  • General Acute Care Hospital
  • Rancho Mirage, CA
  • NPI 1013981554
  NPD (past)

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

• Scripps Health

  dba Scripps Memorial Hospital Encinitas

  • General Acute Care Hospital
  • Encinitas, CA
  • NPI 1700829199
  Care Compare affiliation

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1396905576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORTNIKER",
        "first_name": "ETHAN",
        "middle_name": "ISRAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-11",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A155188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110089060A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Doreen Borseth, D.C.
• Elaine Borseth, DC
• Maya Gaylyn Borso, M.D
• Carissa Borszich
• Adam Christopher Bortner
• Dawn Kristen Bortoluzzi, D.C., B.SC.
• Renato Glosforce Bortoluzzi, DMD
• David L Bortz, M.D., F.A.C.P.
• Elona A Borukhova, L.A.C
• Kaira Milana Borunda

• Gastroenterology Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.