Individual provider Active NPI

Mia Borgatta, IBCLC, RN, LMT, CD

  • Lactation Consultant (Registered Nurse)
  • Brooklyn, NY
National Provider Identifier
1508456898
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
302643 Issued in NY
Practice address
2 E 2ND St # 2
Brooklyn, NY 11218-1020
Phone
(917) 407-6840
NPI assigned
Jan 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 630799 NY
Massage Therapist 225700000X 003538 NY
Doula 374J00000X NY
Lactation Consultant (Registered Nurse) 163WL0100X 302643 NY Primary

Addresses

Primary practice location

2 E 2ND St # 2
Brooklyn, NY 11218-1020

Mailing address

2 E 2ND St # 2
Brooklyn, NY 11218-1020
Phone (917) 407-6840

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
630799NYMDRegistered Nurse
003538NYMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1611187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1508456898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 E 2ND ST # 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112181020",
            "telephone_number": "917-407-6840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 E 2ND ST # 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112181020",
            "telephone_number": "917-407-6840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORGATTA",
        "first_name": "MIA",
        "credential": "IBCLC, RN, LMT, CD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-21",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "630799",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "003538",
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "NY",
            "license": "302643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; 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.