Luis Campos-de-la-Borbolla, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

44107 Issued in TN

Practice address

1265 Union Ave
Suite 184
Memphis, TN 38104-3415

Phone

(901) 516-0929

Fax

(901) 516-8993

NPI assigned

Jul 26, 2006

Last updated

Aug 4, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• University of Maryland Surgcial Assoc PA

  dba University of Maryland Urological Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Baltimore, MD
  • NPI 1083624225
  NPD (past)
• University of Maryland Surgical Associates, PA

  • Specialist
  • Baltimore, MD
  • NPI 1962417634
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1487677548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000",
            "address_2": "DEPT # 457",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381480001",
            "telephone_number": "901-516-0929",
            "fax_number": "901-516-8993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 UNION AVE",
            "address_2": "SUITE 184",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043415",
            "telephone_number": "901-516-0929",
            "fax_number": "901-516-8993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPOS-DE-LA-BORBOLLA",
        "first_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D0060736",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "44107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00873097",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q002436",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170500001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4355465",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosemary Viola Campbell, MPA, RD
• Rukiya S Campbell
• Ryan James Campbell, M.D.
• Saintclare Hickey Campbell, LPC/MPSH
• Tommy J Campbell, MD
• Robert Bradley Canada, MD
• Berenese Canady, PMHNP, APN-BC
• Ann M Canale, NURSE PRACTIONIER
• Dee James Canale, MD
• Meredith Canale, NP

• Surgery Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.