Individual provider Active NPI

Victoria Mary Bordayo

  • Home Health Aide
  • Lansing, MI
National Provider Identifier
1639675697
Registry record updated Mar 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
3411 Pickwick PL
Lansing, MI 48917-1788
Phone
(517) 455-3055
NPI assigned
Mar 30, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chore Provider 372500000X
Home Health Aide 374U00000X Primary

Addresses

Primary practice location

3411 Pickwick PL
Lansing, MI 48917-1788

Mailing address

3411 Pickwick PL
Lansing, MI 48917-1788
Phone (517) 455-3055

Other names 1

  • Victoria Mary Roman Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522368000000",
    "number": "1639675697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3411 PICKWICK PL",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489171788",
            "telephone_number": "517-455-3055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 PICKWICK PL",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489171788",
            "telephone_number": "517-455-3055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDAYO",
        "first_name": "VICTORIA",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-30",
        "last_updated": "2018-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "ROMAN",
            "middle_name": "MARY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2018; 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.