Simon Borucki, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

TRN10164 Issued in FL

Practice address

1231 Coral Way
Riviera Beach, FL 33404-2712

Phone

(813) 476-2623

NPI assigned

Jan 11, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, MO2 enrollments

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.

Enrollment records 2

Specialty

Emergency Medicine

Education

University of South Florida College of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Inphynet Contracting Services LLCGroup PAC ID 7416865811, 169 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Palm Beach Gardens Medical Center Hospital, Palm Beach Gardens, FL, CCN 100176

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Inphynet Contracting Services LLC

  • Emergency Medicine Physician
  • Delray Beach, FL
  • NPI 1073556767
  Medicare reassignment Care Compare group NPD
• Citizens Memorial Hospital District

  • Emergency Medicine Physician
  • Bolivar, MO
  • NPI 1558548818
  Medicare reassignment NPD
• Citizens Memorial Hospital District

  • Community/Retail Pharmacy
  • Buffalo, MO
  • NPI 1427480995
  NPD
• Emergency Services of Zephyrhills PA

  • Emergency Medicine Physician
  • Dade City, FL
  • NPI 1265631097
  NPD (past)
• Acs Emergency Services of Mississippi Professional Association

  • Emergency Medicine Physician
  • Cleveland, MS
  • NPI 1396996997
  NPD (past)
• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555
  NPD (past)
• Acs Primary Care Physicians Louisiana PC

  • Emergency Medicine Physician
  • Alexandria, LA
  • NPI 1306889092
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Palm Beach Gardens Community Hospital, Inc.

  • General Acute Care Hospital
  • Palm Beach Gardens, FL
  • NPI 1144251216
  Care Compare affiliation

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518739200000",
    "number": "1942350079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 CORAL WAY",
            "city": "RIVIERA BEACH",
            "state": "FL",
            "postal_code": "334042712",
            "telephone_number": "813-476-2623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 CORAL WAY",
            "city": "RIVIERA BEACH",
            "state": "FL",
            "postal_code": "334042712",
            "telephone_number": "813-476-2623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORUCKI",
        "first_name": "SIMON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2018-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2018003081",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "TRN10164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lillian Gray Boehmer, PHARMD
• Janette Bogie, M.S.ED., M.PHIL.ED.
• Shonda Boler, IMH-E
• Anthony J Bolson, PHARMD
• Leo Michael Bonfadini, LCSW
• Brittany L Brewton, NURSE PRACTITIONER
• Harold S Brodsky, DDS
• Abigail Brooks, PHARMD
• Pennie R Brooks, LMHC
• Ronitha Lakee Brooks

• Emergency Medicine Physician in Riviera Beach, FL
• Providers in Riviera Beach, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.