Karen Borgoy
Individual provider Active NPI Nurse Practitioner · Keizer, OR
NPI 1871891663 · NPPES record last updated Dec 17, 2021
Key facts
- NPI
- 1871891663
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 201150094NP (OR)
- Practice address
- 5940 Ulali Dr NE
Keizer, OR 97303-1500 - Phone
- (503) 304-5702
- NPI assigned
- Mar 3, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OR, WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120502000371 | OR | Practitioner - Nurse Practitioner | 1557523818 | Reassigns benefits to 1 organization |
| I20241104001881 | WA | Practitioner - Nurse Practitioner | 1557523818 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201150094NP | OR | MD | Nurse Practitioner |
| AP60674291 | WA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Northwest | Current |
Accepting new patients | |
| Kaiser Foundation Health Plan of the Northwest | Current |
Accepting new patients | |
| Kaiser Foundation Health Plan of the Northwest | Current |
Accepting new patients |
Locations
10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946
5940 Ulali Dr NE
Keizer, OR 97303
Phone (503) 304-5738
500 NE Multnomah St
Fl 11
Portland, OR 97232
500 NE Multnomah St
Ste 100
Portland, OR 97232
Phone (503) 499-5200
1160 Wallace Rd NW
Salem, OR 97304
Phone (503) 331-3060
2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400
1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801
7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP60674291 | WA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Nurse Practitioner | 363L00000X | 201150094NP | OR | Yes |
Addresses
Primary practice location
5940 Ulali Dr NE
Keizer, OR 97303-1500
Mailing address
500 NE Multnomah St Ste 100
Portland, OR 97232-2099
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Other |
Other providers in Keizer, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2021. 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.