Mihail Valeriev Borissov, M.D.

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

MD.204610 Issued in LA

Practice address

1214 Coolidge Blvd
Lafayette, LA 70503-2621

Phone

(337) 289-7991

NPI assigned

Jun 4, 2008

Last updated

Jun 16, 2011By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

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

Specialty

Internal MedicineAlso: Emergency Medicine

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coolidge Physician Services LLCGroup PAC ID 7113156035, 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ochsner Lafayette General Medical Center Hospital, Lafayette, LA, CCN 190002

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mborissov1443282@direct.ochsner.org

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.

• Coolidge Physician Services LLC

  • Hospitalist Physician
  • Lafayette, LA
  • NPI 1609298843
  Medicare reassignment Care Compare group NPD
• Hub City Physician Group, LLC

  • Hospitalist Physician
  • Crowley, LA
  • NPI 1992180566
  Medicare reassignment NPD
• St Martin Physician Services LLC

  • Hospitalist Physician
  • Breaux Bridge, LA
  • NPI 1528312584
  Medicare reassignment NPD
• Ambassador Physician Services LLC

  • Hospitalist Physician
  • Lafayette, LA
  • NPI 1134237068
  Medicare reassignment

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

• Lafayette General Medical Center Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1275536799
  Care Compare affiliation

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

{
    "created_epoch": "1212537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308182400000",
    "number": "1679732747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 SETTLERS TRACE BLVD",
            "address_2": "APARTMENT 1404",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086083",
            "telephone_number": "786-218-7989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 COOLIDGE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032621",
            "telephone_number": "337-289-7991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORISSOV",
        "first_name": "MIHAIL",
        "middle_name": "VALERIEV",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-04",
        "last_updated": "2011-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "LA",
            "license": "MD.204610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1082961",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Katherine Bordelon
• Skyi Vincent Bordelon, LPC
• Alison Bordes
• Harold Mark Borel, DDS
• Walter P Borg, M.D.
• Angela Bossier, LPN
• Youssef Estevan Bou-Mikael, MD
• Christy M Boudloche, SPEECH THERAPIST
• Alex Marie Boudreaux, AUD
• Amy Boudreaux, M.S.-CCC, SLP

• Hospitalist Physician in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Hospitalist Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2011; 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.