Amy Borgman, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301013101 Issued in MI

Practice address

697 Hannah Ave
Ste D
Traverse City, MI 49686-3399

Phone

(616) 901-8767

Fax

(844) 218-1127

NPI assigned

Jun 9, 2006

Last updated

Feb 20, 2019By the provider in NPPES

Sex

Female

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 MI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Hackley Life Counseling

  dba Mercy Health - Life Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Muskegon, MI
  • NPI 1912954322
  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1447291687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "697 HANNAH AVE",
            "address_2": "STE D",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863399",
            "telephone_number": "616-901-8767",
            "fax_number": "844-218-1127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "697 HANNAH AVE",
            "address_2": "STE D",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863399",
            "telephone_number": "616-901-8767",
            "fax_number": "844-218-1127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORGMAN",
        "first_name": "AMY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301013101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1712452",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katharene May Bopry
• Leah Borchardt, MA, LLPC
• Borealis Plastic Surgery, PLLC
• Thomas William Borgeld, PH.D.
• Brooke Alice Borgeson-Gray, NP
• Dawn Colleen Borgula, MSN, FNP-BC
• Matthew Born, PHARMD
• Edyta Marta Boron-Freseman
• Michael John Boros, MD
• Daniel J Boss, MD

• Psychologist in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.