Individual provider Active NPI

Alexis Marie Borczuk

  • Licensed Practical Nurse
  • North Syracuse, NY
National Provider Identifier
1487050613
Registry record updated Nov 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
305741-1 Issued in NY
Practice address
7492 Buckley Rd
North Syracuse, NY 13212-1948
Phone
(315) 706-6363
NPI assigned
Nov 17, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 305741-1 NY Primary

Addresses

Primary practice location

7492 Buckley Rd
North Syracuse, NY 13212-1948

Mailing address

7492 Buckley Rd
North Syracuse, NY 13212-1948
Phone (315) 706-6363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
305741-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1416182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416182400000",
    "number": "1487050613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7492 BUCKLEY RD",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132121948",
            "telephone_number": "315-706-6363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7492 BUCKLEY RD",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132121948",
            "telephone_number": "315-706-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORCZUK",
        "first_name": "ALEXIS",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-17",
        "last_updated": "2014-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "305741-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2014; 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.