Brooke E Borys, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4936 Issued in SC

Practice address

1117 48TH Ave N Ste 124
Myrtle Beach, SC 29577-5444

Phone

(858) 621-1514

Fax

(858) 585-4070

NPI assigned

Jul 12, 2024

Last updated

Jul 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in SC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1720742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1861239212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10089 WILLOW CREEK RD STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 48TH AVE N STE 124",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775444",
            "telephone_number": "858-621-1514",
            "fax_number": "858-585-4070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORYS",
        "first_name": "BROOKE",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-12",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan D Bornfreund, D.O.
• Borowicz Vascular PC
• Mark Richard Borowicz, MD
• Anna A Borsic
• Christopher Andrew Borst, MD
• David Bosch, PA-C
• Adam Whitnel Bostick, M.D.
• Edward Botse-Baidoo, M.D
• Elaina Leigh Bouchard
• Kady Boudreaux

• Physician Assistant in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.