Irina V Borissova, MD, PHD

Primary specialty

Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X

License

21550 Issued in MS

Practice address

2500 N State St
Dept. of Anesthesiology
Jackson, MS 39216-4500

Phone

(601) 984-5900

Fax

(601) 984-5939

NPI assigned

Mar 8, 2006

Last updated

Jun 14, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

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.

• Pediatric Anesthesia Consultants of San Antonio PLLC

  • Pediatric Anesthesiology Physician
  • San Antonio, TX
  • NPI 1205089406
  NPD (past)
• Texas Institute of Medicine and Surgery

  • Transplant Surgery Physician
  • San Antonio, TX
  • NPI 1376501668

  Anesthesiology

  NPD (past)

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339632000000",
    "number": "1689641649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "address_2": "DEPT. OF ANESTHESIOLOGY",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5900",
            "fax_number": "601-984-5939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "address_2": "DEPT. OF ANESTHESIOLOGY",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5900",
            "fax_number": "601-984-5939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORISSOVA",
        "first_name": "IRINA",
        "middle_name": "V",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2012-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "N1268",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N1268",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "TX",
            "license": "N1268",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "MS",
            "license": "21550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197750605",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197750601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "N1268",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "197750606",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06276558",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "302I050811",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melody Kristen Boone, MSW
• Tara Jean Booth, NNP-BC
• Emily Boothe
• Joel Christopher Boothe, RN, BSN
• Brian Bahman Borg, MD, MHSC
• Paulo Antonio Borjas Mendoza, MD
• Michael Jude Borne, M.D.
• Barbara Janet Boss, CFNP
• Chandra Anita Boston, C.F.P.M.H.N.P.
• Meredith Celeste Boston, FNP

• Pediatric Anesthesiology Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Pediatric Anesthesiology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; 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.