Active NPI
Dan Borello, MD
- Obstetrics & Gynecology Physician
- Joplin, MO
National Provider Identifier
1912933268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- R7509
- Practice address
- 1532 W 32ND St Ste 301
Joplin, MO 64804-1607 - Phone
- (417) 347-2525
- Fax
- (417) 347-8991
- NPI assigned
- Jun 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | R7509 | MO | Primary |
Addresses
Primary practice location
1532 W 32ND St Ste 301
Joplin, MO 64804-1607
Mailing address
PO Box 3810
Joplin, MO 64803
Phone (417) 347-2525
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200113207 | Medicaid | MO | |
| 100198750A | Medicaid | OK | |
| 160052702 | Other | RR MEDICARE | |
| 100143460B | Medicaid | KS | |
| 6058 | Other | MO | ANTHEM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Ozarks Healthcare
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232928000000",
"number": "1912933268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3810",
"city": "JOPLIN",
"state": "MO",
"postal_code": "64803",
"telephone_number": "417-347-2525",
"fax_number": "417-347-8991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1532 W 32ND ST STE 301",
"city": "JOPLIN",
"state": "MO",
"postal_code": "648041607",
"telephone_number": "417-347-2525",
"fax_number": "417-347-8991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORELLO",
"first_name": "DAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-25",
"last_updated": "2009-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "MO",
"license": "R7509",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200113207",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100198750A",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "160052702",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100143460B",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "6058",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Joplin, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.