Active NPI
Angela M Bornino, ARNP
- Gerontology Nurse Practitioner
- Minneapolis, MN
National Provider Identifier
1760904841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 11089
- Practice address
- 800 E 28TH St
Minneapolis, MN 55407-3723 - Phone
- (651) 635-9173
- Fax
- (651) 628-2999
- NPI assigned
- Jul 11, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704326984 | MI | |
| Adult Health Nurse Practitioner | 363LA2200X | AP60928364 | WA | |
| Gerontology Nurse Practitioner | 363LG0600X | 11089 | MN | Primary |
Addresses
Primary practice location
800 E 28TH St
Minneapolis, MN 55407-3723
Mailing address
550 Gage Blvd Ste 101
Richland, WA 99352-9532
Phone (509) 942-3627
Other practice location 1
560 Gage Blvd Ste 203
Richland, WA 99352-8650
Phone (509) 942-3135
Other practice location 2
2100 Raybrook St SE Ste 303
Grand Rapids, MI 49546-5783
Phone (616) 235-5100
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | abornino1106623@wm.providencedirect.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240130000714 | MN | Practitioner - Nurse Practitioner | 6901179340 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Allina Health System
Practice addresses (Care Compare)
800 E 28TH St
Minneapolis, MN 55407-3723
Phone (612) 863-4762
Hospital & facility affiliations
- Abbott Northwestern Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.6 of 100
- Quality
- 72.5
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.07
Merit-based Incentive Payment System (MIPS)
- Final score
- 53.61 of 100
- Quality
- 21.35
- Promoting interoperability
- 100
- Improvement activities
- 0
- Cost
- 74.01
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP60928364 | WA | MD | Adult Health Nurse Practitioner |
| 11089 | MN | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allina Health System | Current | Accepting new patients | |
| Allina Health System | Current | Accepting new patients | |
| Allina Health System | Current | Accepting new patients | |
| Allina Health System | Past | Accepting new patients |
Locations
2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640
4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786
800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547
2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813
1455 Saint Francis Ave
Shakopee, MN 55379
Phone (952) 403-2200
Interoperability endpoints
- abornino1106623@wm.providencedirect.org
Organizations & group practices 4
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.
-
- Rheumatology Physician
- Coon Rapids, MN
- NPI 1952146516
-
- Internal Medicine Physician
- New Ulm, MN
- NPI 1992748966
-
- Family Medicine Physician
- Minneapolis, MN
- NPI 1467758813
Hospital & facility affiliations 23
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Obesity Medicine (Family Medicine) Physician
- Minneapolis, MN
- NPI 1154684835
Hospital
-
- Physical Medicine & Rehabilitation Physician
- Minneapolis, MN
- NPI 1275577215
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718582400000",
"number": "1760904841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 GAGE BLVD STE 101",
"city": "RICHLAND",
"state": "WA",
"postal_code": "993529532",
"telephone_number": "509-942-3627",
"fax_number": "509-627-2983"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 E 28TH ST",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554073723",
"telephone_number": "651-635-9173",
"fax_number": "651-628-2999"
}
],
"practiceLocations": [
{
"address_1": "560 Gage Blvd Ste 203",
"address_purpose": "LOCATION",
"city": "Richland",
"state": "WA",
"postal_code": "993528650",
"country_code": "US",
"telephone_number": "509-942-3135",
"fax_number": "509-627-1188",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2100 Raybrook St SE Ste 303",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495465783",
"country_code": "US",
"telephone_number": "616-235-5100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BORNINO",
"first_name": "ANGELA",
"middle_name": "M",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-11",
"last_updated": "2024-06-17",
"certification_date": "2024-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704326984",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "WA",
"license": "AP60928364",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "MN",
"license": "11089",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "abornino1106623@wm.providencedirect.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "560 Gage Blvd Ste 203",
"city": "Richland",
"state": "WA",
"country_code": "US",
"postal_code": "993528650",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; 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.