David Burton Bork, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD00017381 Issued in WA

Practice address

19020 33Rd Ave W Ste 210
Lynnwood, WA 98036

Phone

(425) 563-1500

Fax

(425) 563-1501

NPI assigned

Jan 6, 2006

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 5

Medicare fee-for-service enrollment

Enrolled in WA, ID2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Obstetrix Medical Group of Washington Inc PS

  • Maternal & Fetal Medicine Physician
  • Seattle, WA
  • NPI 1861599573
  Medicare reassignment NPD
• Okanogan County Public Hospital Dist No 4

  • Medical Specialty Clinic/Center
  • Tonasket, WA
  • NPI 1750443834
  Medicare reassignment NPD
• Optum Care Washington PLLC

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1831186766
  Medicare reassignment NPD
• Radia Inc P S

  • Diagnostic Radiology Physician
  • Lynnwood, WA
  • NPI 1932196607

  ID

  Medicare reassignment
• Okanogan County Public Hospital Dist No 4

  • Rural Health Clinic/Center
  • Tonasket, WA
  • NPI 1811555931
  NPD
• Optum Care Washington PLLC

  • Durable Medical Equipment & Medical Supplies
  • Marysville, WA
  • NPI 1194428425
  NPD
• Optum Care Washington PLLC

  • Ambulatory Surgical Clinic/Center
  • Arlington, WA
  • NPI 1366154304
  NPD
• Public Hospital District No 4, King County Wa

  • Family Medicine Physician
  • Snoqualmie, WA
  • NPI 1144432634
  NPD (past)
• Seattle Nuclear Medicine-Ultrasound Associates

  • Radiology Clinic/Center
  • Seattle, WA
  • NPI 1265506349
  NPD (past)
• Swedish Medical Center-Radia Issaquah Imaging Center LLC

  • Diagnostic Radiology Physician
  • Issaquah, WA
  • NPI 1427001312
  NPD (past)

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531440000000",
    "number": "1700864014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W STE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364748",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W STE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "98036",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORK",
        "first_name": "DAVID",
        "middle_name": "BURTON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2018-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "M-12326",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD00017381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700864014",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I PROVIDER NUMBER",
            "identifier": "189513",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I PROVIDER NUMBER",
            "identifier": "189514",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8195000",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I PROVIDER NUMBER",
            "identifier": "189512",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eliana Bonilla
• Emily Boober
• Lauren E Bopp, RN
• Stanley D Borish, MD
• Kendal Ilyse Borison, BCAT, RBT
• Roz R. Bornstein, LICSW, MSW
• Julie Ann Borovik, MA, LMFT
• Ingrid Borrero
• Iman Warsame Bot, PROVIDER RN
• Gini Bouche

• Diagnostic Radiology Physician in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Diagnostic Radiology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.