Active NPI
Jonathan D Bornfreund, D.O.
- Family Medicine Physician
- Myrtle Beach, SC
National Provider Identifier
1689634289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 0708
- Practice address
- 106 Lansford CT.
Suite 100
Myrtle Beach, SC 29588 - Phone
- (843) 293-8850
- Fax
- (843) 293-8860
- NPI assigned
- Mar 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0708 | SC | Primary |
Addresses
Primary practice location
106 Lansford CT.
Suite 100
Myrtle Beach, SC 29588
Mailing address
106 Lansford CT.
Suite 100
Myrtle Beach, SC 29588
Phone (843) 293-8850
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 153867800 | Other | SC | DEPARTMENT OF LABOR |
| 193683 | Other | SC | MEDCOST |
| 7198502 | Other | SC | CIGNA |
| P00057006 | Other | SC | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20031202000094 | SC | Practitioner - Family Practice | 2668377805 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of New Mexico School of Medicine, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Family Medicine of Sayebrook LLC
Practice addresses (Care Compare)
106 Lansford CT
Suite 100
Myrtle Beach, SC 29588-3501
Phone (843) 293-8850
Hospital & facility affiliations
- Centerwell Home Health
- Amedisys Home Health of Myrtle Beach
- Well Care Home Health of the Lowcountry Inc
- Amedisys Home Health of Conway
- Grand Strand Regional Medical Center
- Conway Medical Center
- Tidelands Waccamaw Community Hospital
- Tidelands Georgetown Memorial Hospital
- McLeod Loris Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 13 |
| Removal of skin lesions | 154 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 19 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0708 | SC | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Medicine of Sayebrook, LLC | Current | Accepting new patients | |
| Advantage Health Center, LLC | Family Medicine | Past | Accepting new patients |
| PH Health Care Services Inc | Family Medicine | Past | Accepting new patients |
Locations
106 Lansford Ct
Ste 100
Myrtle Beach, SC 29588
Phone (843) 293-8850
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/HEHFAD
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 and National Provider Directory roles.
-
- Primary Care Clinic/Center
- Myrtle Beach, SC
- NPI 1942791090
-
- Family Medicine Physician
- Myrtle Beach, SC
- NPI 1598742041
Family Medicine
-
- Community Based Hospice Care Agency
- Easley, SC
- NPI 1134491616
Family Medicine
Hospital & facility affiliations 22
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Conway, SC
- NPI 1316905573
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220918400000",
"number": "1689634289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 LANSFORD CT.",
"address_2": "SUITE 100",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "29588",
"telephone_number": "843-293-8850",
"fax_number": "843-293-8860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 LANSFORD CT.",
"address_2": "SUITE 100",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "29588",
"telephone_number": "843-293-8850",
"fax_number": "843-293-8860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORNFREUND",
"first_name": "JONATHAN",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-27",
"last_updated": "2008-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "0708",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF LABOR",
"identifier": "153867800",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "193683",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "7198502",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00057006",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; 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.