Tiffany Yue-Fei Borbon, MD, PHD
Individual provider Active NPI Pediatrics Physician · Fairbanks, AK
NPI 1760019665 · NPPES record last updated Nov 18, 2023
Key facts
- NPI
- 1760019665
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 212194 (AK)
- Practice address
- 1650 Cowles St
Fairbanks, AK 99701-5907 - Phone
- (907) 452-8181
- NPI assigned
- Mar 23, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231109000117 | AK | Practitioner - Pediatric Medicine | 3577986058 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD61402504 | WA | MD | Pediatrics Physician |
| ML61058271 | WA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tanana Valley Clinic LLC | Current |
Accepting new patients | |
| Tanana Valley Clinic LLC | Current |
Accepting new patients | |
| Fairbanks Memorial Hospital, LLC | Past | Accepting new patients |
Locations
1650 Cowles St
Fairbanks, AK 99701
Phone (907) 452-8181
1001 Noble St
Fairbanks, AK 99701
Phone (907) 276-2806
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ML61058271 | WA | |
| Pediatrics Physician | 208000000X | MD61402504 | WA | |
| Pediatrics Physician | 208000000X | 212194 | AK | Yes |
Addresses
Primary practice location
1650 Cowles St
Fairbanks, AK 99701-5907
Mailing address
1650 Cowles St
Fairbanks, AK 99701-5907
Phone (907) 452-8181
Other providers in Fairbanks, AK
- Amber Bonham
- Anthony J Bonitatibus
- Jazlene Bonny
- Krista Melody Boone
- Debra Catherine Booysen
- Boreal Futures, LLC
- Borealis Assisted Living, LLC
- Kendel Lynn Bormann
- Brenda Bornt-Johnson
- Jon Borseth
All providers in Fairbanks, AK · Pediatrics Physician in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.