NPIMap

Individual provider Active NPI

Albert R Boroughs IV, MD

  • Family Medicine Physician
  • Monroeville, AL
National Provider Identifier
1740283548
Registry record updated Mar 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
00022765 Issued in AL
Practice address
75 Highway 136 W
Monroeville, AL 36460
Phone
(251) 575-4825
Fax
(251) 575-7730
NPI assigned
May 24, 2005
Last updated
Mar 5, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 00022765 AL Primary

Addresses

Primary practice location

75 Highway 136 W
Monroeville, AL 36460

Mailing address

75 Highway 136 W
Monroeville, AL 36460
Phone (251) 575-4825

Other identifiers 3

IdentifierTypeStateIssuer
02327OtherALBCBS PROVIDER #
009958120MedicaidAL
080173663OtherALRR MEDICARE PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100803000172 AL Practitioner - Family Practice 0547205270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Alabama College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors Clinic of Monroeville PCGroup PAC ID 2567406796, 2 clinicians

Practice addresses (Care Compare)

75 Hwy 136 W
Monroeville, AL 36460-8958
Phone (251) 575-4825

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00022765ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Clinic of Monroeville PC Family Medicine CurrentSince Aug 1, 2001 Accepting new patients

Locations

1772 S Alabama Ave
Monroeville, AL 36460
Phone (251) 575-4825

75 Highway 136 W
Monroeville, AL 36460
Phone (251) 575-4825

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hospice of Monroe CountyMonroeville, AL, CCN 011685 Hospice Corporate Director (5%) Oct 1, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 1

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236211200000",
    "number": "1740283548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 HIGHWAY 136 W",
            "city": "MONROEVILLE",
            "state": "AL",
            "postal_code": "36460",
            "telephone_number": "251-575-4825",
            "fax_number": "251-575-7730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 HIGHWAY 136 W",
            "city": "MONROEVILLE",
            "state": "AL",
            "postal_code": "36460",
            "telephone_number": "251-575-4825",
            "fax_number": "251-575-7730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOROUGHS",
        "first_name": "ALBERT",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2009-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "00022765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "02327",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009958120",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PROVIDER #",
            "identifier": "080173663",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroeville, AL

Sources for this page

Verify at the official NPI Registry.