Shannon Yvonne Borrego, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1825 Issued in AZ

Practice address

483 W. Seed Farm Rd
Sacaton, AZ 85147

Phone

(602) 528-1200

NPI assigned

Aug 10, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

Southern California College of Optometry, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Adam J Lee PCGroup PAC ID 6709009731, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.21 of 100Reported as group

Quality

76.88

Promoting interoperability

76

Improvement activities

40

Cost

73.83

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Adam J. Lee, PC

  • Optometrist
  • Avondale, AZ
  • NPI 1912321464

  AZ, Optometrist

  Medicare reassignment Care Compare group NPD
• Gila River Health Care Corporation

  • Critical Access Hospital
  • Laveen, AZ
  • NPI 1376538231

  TX

  Medicare reassignment NPD
• Gila River Health Care

  • Community/Behavioral Health Agency
  • Laveen, AZ
  • NPI 1598021495
  NPD
• Gila River Health Care Corporation

  • Critical Access Hospital
  • Sacaton, AZ
  • NPI 1225023179
  NPD
• Gila River Health Care Corporation

  • Rural Acute Care Hospital
  • Maricopa, AZ
  • NPI 1386633915
  NPD
• Emilio Martin Justo MD PC

  • Ophthalmology Physician
  • Sun City, AZ
  • NPI 1801902762
  NPD (past)
• Lilien Vogl OD PC

  • Medical Specialty Clinic/Center
  • Avondale, AZ
  • NPI 1699966762
  NPD (past)

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

{
    "created_epoch": "1312934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446595200000",
    "number": "1497034342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38",
            "city": "SACATON",
            "state": "AZ",
            "postal_code": "851470001",
            "telephone_number": "602-528-1200",
            "fax_number": "602-528-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 W. SEED FARM RD",
            "city": "SACATON",
            "state": "AZ",
            "postal_code": "85147",
            "telephone_number": "602-528-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORREGO",
        "first_name": "SHANNON",
        "middle_name": "YVONNE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-10",
        "last_updated": "2015-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "640201",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wendolyn Bitselley Calderon, FNP-C
• Joyce Mary Blair
• Larissa Joelle Bloom, LASAC
• Ina Blue, LCSW
• Michael Bond, D.P.T.
• Renee Boudreau
• Cassi Bouton
• William Dale Bradford, MA,LISAC
• Robert Wade Brandimore, LBSW
• Gloria A Bravo-Gutierrez, LMSW

• All providers in Sacaton, AZ
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2015; 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.
• 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.