Active NPI
Roy Myron Bordenick, M.S.
- Audiologist
- Baltimore, MD
National Provider Identifier
1962494500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- MD00126
- Practice address
- 7658A Belair Rd
Baltimore, MD 21236-4088 - Phone
- (410) 668-9198
- Fax
- (410) 668-1075
- NPI assigned
- Aug 19, 2005
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | MD00126 | MD | Primary |
Addresses
Primary practice location
7658A Belair Rd
Baltimore, MD 21236-4088
Mailing address
18 Old Plantation Way
Baltimore, MD 21208-6370
Phone (410) 484-1235
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00061325 | Other | MD | PALMETTO RR MEDICARE |
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00126 | MD | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219881600000",
"number": "1962494500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 OLD PLANTATION WAY",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212086370",
"telephone_number": "410-484-1235",
"fax_number": "410-668-1075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7658A BELAIR RD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212364088",
"telephone_number": "410-668-9198",
"fax_number": "410-668-1075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORDENICK",
"first_name": "ROY",
"middle_name": "MYRON",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-19",
"last_updated": "2008-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MD",
"license": "MD00126",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO RR MEDICARE",
"identifier": "P00061325",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.