NPIMap

Individual provider Active NPI

Sam Austin Bores, MD

  • Emergency Medicine Physician
  • Jbsa Ft Sam Houston, TX
National Provider Identifier
1831509157
Registry record updated May 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
R4521 Issued in TX
Practice address
3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234
Phone
(339) 222-8918
NPI assigned
May 8, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X
Emergency Medicine Physician 207P00000X R4521 TX Primary

Addresses

Primary practice location

3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234

Mailing address

3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504
Phone (339) 222-8918

Other practice location 1

170 Manning Dr
CB # 7594
Chapel Hill, NC 27599-7594
Phone (919) 966-6442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210714000708 NC Practitioner - Emergency Medicine 4486879590 Reassigns benefits to 5 organizations
I20221108000876 SC Practitioner - Emergency Medicine 4486879590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Perelman School of Med at the University of Pennsylvania, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest Emergency ProvidersGroup PAC ID 7012819816, 497 clinicians

Practice addresses (Care Compare)

920 Church St N
Concord, NC 28025-2927
Phone (704) 403-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stallings Emergency Physicians, PLLC Emergency Medicine CurrentSince Dec 1, 2021 Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Nov 1, 2022 Accepting new patients
The Carolinas Emergency Group, PLLC Emergency Medicine CurrentSince Jun 1, 2021 Accepting new patients
Emergency Medicine Physicians of Mecklenburg County, PLLC Emergency Medicine CurrentSince Jul 15, 2021 Accepting new patients
Wake Forest Emergency Providers CurrentSince Aug 5, 2024 Accepting new patients
Ballantyne Emergency Physicians PLLC Emergency Medicine CurrentSince Sep 10, 2021 Accepting new patients
Ballantyne Emergency Physicians PLLC Emergency Medicine CurrentSince Sep 10, 2021 Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

2001 Vail Ave
Charlotte, NC 28207
Phone (704) 304-5000

10628 Park Rd
Charlotte, NC 28210
Phone (704) 543-2000

11516 Providence Rd
Charlotte, NC 28277
Phone (704) 667-0370

16035 Johnston Rd
Charlotte, NC 28277
Phone (704) 542-5132

920 Church St N
Concord, NC 28025
Phone (704) 403-3000

1000 Healing Way
Matthews, NC 28104
Phone (800) 821-1535

600 Hospital Dr
Monroe, NC 28112
Phone (704) 283-3100

2301 US Highway 74 W
Wadesboro, NC 28170
Phone (704) 694-5131

2700 S Providence Rd
Waxhaw, NC 28173
Phone (704) 243-2254

971 Gold Hill Rd
Fort Mill, SC 29708
Phone (803) 329-1234

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

222 Herlong Ave S
Rock Hill, SC 29732
Phone (803) 324-1950

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 7

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.

Hospital & facility affiliations 10

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": "1399507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526688000000",
    "number": "1831509157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "339-222-8918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "78234",
            "telephone_number": "339-222-8918"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "170 Manning Dr",
            "address_2": "CB # 7594",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275997594",
            "country_code": "US",
            "telephone_number": "919-966-6442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORES",
        "first_name": "SAM",
        "middle_name": "AUSTIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-08",
        "last_updated": "2018-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "R4521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa Ft Sam Houston, TX

Sources for this page

Verify at the official NPI Registry.