Individual provider Active NPI

Rachel Borlack

  • Pediatric Gastroenterology Physician
  • Bronx, NY
National Provider Identifier
1649698325
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
281951 Issued in NY
Practice address
3411 Wayne Ave FL 7
Bronx, NY 10467-2552
Phone
(717) 741-2332
NPI assigned
Mar 31, 2014
Last updated
May 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 281951 NY Primary

Addresses

Primary practice location

3411 Wayne Ave FL 7
Bronx, NY 10467-2552

Mailing address

3411 Wayne Ave FL 7
Bronx, NY 10467-2552
Phone (718) 741-2332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200821000887 NY Practitioner - Pediatric MedicinePractitioner - Gastroenterology 3173862729 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jun 17, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Jun 17, 2022 Accepting new patients
University at Buffalo Pediatric Associates Inc CurrentSince Sep 1, 2020 Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1001 Main St
Fl 4
Buffalo, NY 14203
Phone (716) 636-8284

1001 Main St
Fl 5
Buffalo, NY 14203
Phone (716) 323-0031

1404 Sweet Home Rd
Buffalo, NY 14228
Phone (716) 932-6060

1404 Sweet Home Rd
Ste 56
Buffalo, NY 14228
Phone (716) 639-9361

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: raborlack@montefioredirect.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1649698325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3411 WAYNE AVE FL 7",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672552",
            "telephone_number": "718-741-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 WAYNE AVE FL 7",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672552",
            "telephone_number": "717-741-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORLACK",
        "first_name": "RACHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-31",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NY",
            "license": "281951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.