Boris Krasimirov Todorov, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

7256 Issued in OH

Practice address

500 Burlington Rd
Suite 240
Jackson, OH 45640-9360

Phone

(740) 286-5075

Fax

(740) 395-8411

NPI assigned

Feb 25, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Behavioral Health Cooperative LLCGroup PAC ID 1355732777, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Behavioral Health Cooperative, LLC

  dba Primary Care Psychology Associates

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1497428817
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1424822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498694400000",
    "number": "1740672963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SKOKIE BLVD",
            "address_2": "STE 245",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600627932",
            "telephone_number": "847-686-0090",
            "fax_number": "847-686-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 BURLINGTON RD",
            "address_2": "SUITE 240",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456409360",
            "telephone_number": "740-286-5075",
            "fax_number": "740-395-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODOROV",
        "first_name": "BORIS",
        "middle_name": "KRASIMIROV",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-25",
        "last_updated": "2017-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "7256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0200820",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krystal Marie Thayer, PA-C
• The Kroger Co (Kroger Pharmacy)
• Kayla Thomas
• David L Thompson
• Aundrea Jill Tipton, CNP
• Cassandra Toney, LSW
• Total Renal Care Inc (McCarty Lane Dialysis)
• Autumn Susan Trace, LPN
• Alexander Triplett
• Sandra Lee Troester, CRNA

• Clinical Psychologist in Jackson, OH
• Providers in Jackson, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2017; 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.

Verify at the official NPI Registry.