Boris Havkin PLLC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

ME90111 Issued in FL

Legal business name

BORIS HAVKIN PLLC

Practice address

3021 W Eau Gallie Blvd
Suite 103
Melbourne, FL 32934-7005

Phone

(321) 500-4545

NPI assigned

Mar 14, 2016

Organization subpart

No

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

Authorized official

Name

Boris Havkin, MDNPI 1609867696

Title

Business Owner

Phone

(321) 500-4545

Specialties & licenses 1

Addresses

Other names 1

• HAVKIN UROLOGY Other name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13960/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Boris Havkin, MD

  • Urology Physician
  • Melbourne, FL
  • NPI 1609867696
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1457913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473206400000",
    "number": "1679934996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3021 W EAU GALLIE BLVD",
            "address_2": "SUITE 103",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329347005",
            "telephone_number": "321-500-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3021 W EAU GALLIE BLVD",
            "address_2": "SUITE 103",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329347005",
            "telephone_number": "321-500-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BORIS HAVKIN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-14",
        "last_updated": "2016-09-07",
        "status": "A",
        "authorized_official_last_name": "HAVKIN",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "321-500-4545",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "FL",
            "license": "ME90111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HAVKIN UROLOGY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• John Booher, BCABA
• Elizabeth Boone
• Marie Boone, APRN, FNP-C
• Richard Borck, B.S., EMT-B
• Glori Borges, M.A., LMHC
• Kaylee Anice Bormuth
• Brent Boro, ARNP
• Elizabeth Borrero, M.D.
• Donna Borresen, AP
• Sandra Suzanne Borthwick, BSW

• Urology Physician in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.