NPIMap

Individual provider Active NPI

Stuart H. Borken, MD

  • Gastroenterology Physician
  • Minneapolis, MN
National Provider Identifier
1487653564
Registry record updated Mar 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
17696 Issued in MN
Practice address
825 South 8TH Street
Suite 600, Attn: Parkside Professional BLDG.
Minneapolis, MN 55404
Phone
(612) 339-7171
Fax
(612) 339-2885
NPI assigned
Jul 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 17696 MN Primary

Addresses

Primary practice location

825 South 8TH Street
Suite 600, Attn: Parkside Professional BLDG.
Minneapolis, MN 55404

Mailing address

825 South 8TH Street
Suite 600, Attn: Parkside Professional BLDG.
Minneapolis, MN 55404
Phone (612) 339-7171

Other identifiers 4

IdentifierTypeStateIssuer
NP19648OtherMNHEALTH PARTNERS
110185091OtherMNRR MEDICARE
396068400MedicaidMN
0406696OtherMNMEDICA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17696MNMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Internists, PA Current Accepting new patients

Locations

825 S 8th St
Ste 600
Minneapolis, MN 55404
Phone (612) 339-7171

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300924800000",
    "number": "1487653564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 SOUTH 8TH STREET",
            "address_2": "SUITE 600, ATTN: PARKSIDE PROFESSIONAL BLDG.",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55404",
            "telephone_number": "612-339-7171",
            "fax_number": "612-339-2885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 SOUTH 8TH STREET",
            "address_2": "SUITE 600, ATTN: PARKSIDE PROFESSIONAL BLDG.",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55404",
            "telephone_number": "612-339-7171",
            "fax_number": "612-339-2885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORKEN",
        "first_name": "STUART",
        "middle_name": "H.",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2011-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MN",
            "license": "17696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "NP19648",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110185091",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "396068400",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0406696",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; 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.