Thea Mae Bordenave-Sande, D.O.

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

60-270606 Issued in NY

Practice address

77 Van Dam St
Suite 12
Saratoga Springs, NY 12866-2023

Phone

(518) 587-0801

Fax

(518) 587-0849

NPI assigned

Sep 9, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 11, 2016 through Feb 11, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378684800000",
    "number": "1811279458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 VAN DAM ST",
            "address_2": "SUITE 12",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128662023",
            "telephone_number": "518-587-0801",
            "fax_number": "518-587-0849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 VAN DAM ST",
            "address_2": "SUITE 12",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128662023",
            "telephone_number": "518-587-0801",
            "fax_number": "518-587-0849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDENAVE-SANDE",
        "first_name": "THEA",
        "middle_name": "MAE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-09",
        "last_updated": "2013-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "NY",
            "license": "60-270606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Bogovich, RN, FNP-BC
• Chelsea M Bolles, LMHC
• Steven Bombard, PHARMD
• Eric C. Borden, M.D.
• Jennifer Lynn Borden, M.D.
• Patricia A Bosen, FNP
• Lorelei Natasha Bourla, M.D.
• Michael Bourla, M.D.
• Norman Bovee, PA
• Katherine Patricia Bowen, LCSW

• Neuromusculoskeletal Medicine & OMM Physician in Saratoga Springs, NY
• Providers in Saratoga Springs, NY by specialty
• Neuromusculoskeletal Medicine & OMM Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.