Inner Balance Integrative Medicine, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

77100 Issued in MA

Legal business name

INNER BALANCE INTEGRATIVE MEDICINE, LLC

Practice address

65 Walnut St
Suite 380
Wellesley, MA 02481-2118

Phone

(781) 239-9900

Fax

(781) 239-9953

NPI assigned

Jun 19, 2012

Organization subpart

No

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

Authorized official

Name

John Bordiuk, MDNPI 1568571396

Title

Owner

Phone

(781) 454-9014

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• Direct secure messaging: sheiber.amy.ibim@direct.partners.masshiway.net
• Direct secure messaging: bordiuk.john.ibim@direct.partners.masshiway.net

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Bordiuk, MD

  • Internal Medicine Physician
  • Wellesley, MA
  • NPI 1568571396
  Medicare reassignment Care Compare group NPD Authorized official
• Amy Groszyk Sheiber, FNP-BC

  • Family Nurse Practitioner
  • Framingham, MA
  • NPI 1265760599
  Medicare reassignment Care Compare group NPD
• Nina P. Schussler, FNP

  • Family Medicine Physician
  • Needham, MA
  • NPI 1740959105
  NPD

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366848000000",
    "number": "1487917993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 WALNUT ST",
            "address_2": "SUITE 380",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024812118",
            "telephone_number": "781-454-9014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 WALNUT ST",
            "address_2": "SUITE 380",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024812118",
            "telephone_number": "781-239-9900",
            "fax_number": "781-239-9953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER BALANCE INTEGRATIVE MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-19",
        "last_updated": "2013-04-25",
        "status": "A",
        "authorized_official_last_name": "BORDIUK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-454-9014",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "77100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA CERTIFICATION",
            "identifier": "22D2048592",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ilya Sherman DMD PC
• Caitlin Ann Imbrogno, O.D.
• Edual Infante Sr., CHW
• John U Ingard, M.D.
• Leonard H Inker, M.D.
• Karen Theo Isselbacher, MD
• Cahrina Geonye Jackson
• Nadia Jackson, LMHC
• Anne L Jacobs
• Shirley D. Jacobson, LICSW

• Internal Medicine Physician in Wellesley, MA
• Providers in Wellesley, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.