Michael Boersen, BA, HAD

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

HA8045 Issued in CA

Practice address

16 E Fern Ave Ste C
Redlands, CA 92373-4000

Phone

(909) 792-0074

NPI assigned

Apr 17, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

State licenses

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1417510249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 E FERN AVE STE C",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734000",
            "telephone_number": "909-792-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 E FERN AVE STE C",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734000",
            "telephone_number": "909-792-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOERSEN",
        "first_name": "MICHAEL",
        "credential": "BA, HAD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-17",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "CA",
            "license": "HA8045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14549148",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.redlandsprofessionalhearingcenter.com",
            "affiliation": "N",
            "endpointDescription": "Redlands Professional Hearing Center Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Website",
            "address_1": "16 E Fern Ave Ste C",
            "city": "Redlands",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923734000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Hearing Instrument Specialist in Redlands, CA
• Providers in Redlands, CA by specialty
• Hearing Instrument Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.