Stanislav Borodyansky, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

25MP00506000 Issued in NJ

Practice address

3 Cooper PLZ RM 408
Camden, NJ 08103

Phone

(856) 968-7363

NPI assigned

Jun 22, 2016

Last updated

May 8, 2019By 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 4

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, NJ2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cooper Surgical Associates, PAGroup PAC ID 3274430764, 303 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cooper University Hospital Hospital, Camden, NJ, CCN 310014
• West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cooper Surgical Associates, PA

  • Orthopaedic Surgery Physician
  • Voorhees, NJ
  • NPI 1427177195
  Medicare reassignment Care Compare group
• Aria Health Physician Services

  dba Richboro Medical

  • Family Medicine Physician
  • Richboro, PA
  • NPI 1750949806
  Medicare reassignment
• Cooper Surgical Associates, PA

  • Surgery Physician
  • Camden, NJ
  • NPI 1649217514
  NPD
• Aria Health Physician Services

  dba Geoffrey W. Temple Family Medical Associates

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1053181297
  NPD
• Aria Health Physician Services

  • Emergency Registered Nurse
  • Philadelphia, PA
  • NPI 1598893893
  NPD
• Aria Health Orthopaedics

  • Orthopaedic Surgery Physician
  • Langhorne, PA
  • NPI 1376895342
  NPD (past)
• Aria Health Physician Services

  dba Aria Health Physician Services - Bucks Surgery

  • Surgery Physician
  • Langhorne, PA
  • NPI 1114981123
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Cooper Health System

  dba Cooper University Hospital

  • Land Ambulance
  • Camden, NJ
  • NPI 1174976724

  Hospital

  Care Compare affiliation
• The Cooper Health System

  • General Acute Care Hospital
  • Camden, NJ
  • NPI 1568442309
  Care Compare affiliation
• Virtua - West Jersey Health System, Inc.

  • General Acute Care Hospital
  • Voorhees, NJ
  • NPI 1528064409
  Care Compare affiliation

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1619328564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST # 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 COOPER PLZ RM 408",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "08103",
            "telephone_number": "856-968-7363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "380 Oxford Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Langhorne",
            "state": "PA",
            "postal_code": "190478304",
            "country_code": "US",
            "telephone_number": "888-678-4632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORODYANSKY",
        "first_name": "STANISLAV",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-22",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00506000",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA058251",
            "primary": false
        },
        {
            "code": "364SE0003X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Emergency",
            "state": "PA",
            "license": "PROCESSING",
            "primary": false
        },
        {
            "code": "364SM0705X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Medical-Surgical",
            "state": "PA",
            "license": "PROCESSING",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke Anne Bonnette, PA-C
• John Daniel Boos Jr., MD
• Maureen Anita Booth, APRN
• Navdeep K Boparai
• Amy Bordogna, MD, MPH
• Michael D. Borowiec, LPC, LCADC
• Gayatri Borra, M.D.
• Daniel Borrero
• Rachel Anne Bosco, CRNA, DNP, RN, BSN
• Sucharitha Bose

• Surgical Physician Assistant in Camden, NJ
• Providers in Camden, NJ by specialty
• Surgical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; 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.