NPIMap

Individual provider Active NPI

Ivan Borbon, DO

  • Internal Medicine Physician
  • Tucson, AZ
National Provider Identifier
1487036679
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2015020390 Issued in MO
Practice address
3978 N Campbell Ave
Tucson, AZ 85719-1460
Phone
(520) 325-3978
Fax
(520) 325-3985
NPI assigned
Jun 24, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2015020390 MO Primary

Addresses

Primary practice location

3978 N Campbell Ave
Tucson, AZ 85719-1460

Mailing address

PO Box 65177
Tucson, AZ 85728-5177
Phone (520) 635-9103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180611001690 AZ Practitioner - Internal Medicine 7214244664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathways Medical PartnersGroup PAC ID 0749560647, 10 clinicians

Practice addresses (Care Compare)

1700 E River Rd
Suite 65177
Tucson, AZ 85728-3049
Phone (520) 635-9103

Hospital & facility affiliations

  • Haven Home Health Care Home health agency, Tucson, AZ, CCN 037494
  • Catalina Hospice PLLC Hospice, Tucson, AZ, CCN 031742
  • Tucson Medical Center Hospital, Tucson, AZ, CCN 030006
  • Park Avenue Health and Rehabilitation Center Nursing home, Tucson, AZ, CCN 035174
  • Splendido at Rancho Vistoso Nursing home, Tucson, AZ, CCN 035273

Merit-based Incentive Payment System (MIPS)

Final score
96.68 of 100Reported as group
Quality
100
Improvement activities
40
Cost
69.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Medical Partners CurrentSince Dec 16, 2019 Accepting new patients
Pathways Medical Partners Current Accepting new patients
Catalina Hospice PLLC CurrentSince Mar 7, 2021 Accepting new patients
Handmaker Jewish Services for the Aging Past Accepting new patients
Park Waverly Healthcare LLC Past Accepting new patients

Locations

1700 E River Rd
Unit 65177
Tucson, AZ 85728
Phone (520) 635-9103

2675 N Wyatt Dr
Tucson, AZ 85712
Phone (520) 260-0937

3978 N Campbell Ave
Tucson, AZ 85719
Phone (520) 325-3978

Interoperability endpoints

  • Direct secure messaging: ivan.borbon.1@25270.direct.athenahealth.com
  • Direct secure messaging: iborbon18106@elrio.direct.ci.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Catalina Hospice PLLCTucson, AZ, CCN 031742 Hospice 5% Or Greater Direct Ownership Interest (40%)
Corporate Director (100%)
Operational/Managerial Control (100%)		 Jul 23, 2020
Jul 23, 2020
Jul 23, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Catalina Hospice PLLC
    • Community Based Hospice Care Agency
    • Tucson, AZ
    • NPI 1396351235

    5% Or Greater Direct Ownership Interest, Corporate Director, Operational/Managerial Control

    CMS ownership

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1487036679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 65177",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857285177",
            "telephone_number": "520-635-9103",
            "fax_number": "520-336-9179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3978 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857191460",
            "telephone_number": "520-325-3978",
            "fax_number": "520-325-3985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORBON",
        "first_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-24",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2015020390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.