Individual provider Active NPI

Paul Borgesen Jr., MPAS, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1962594861
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2389 Issued in AZ
Practice address
13838 S 46TH PL
Suite 120
Phoenix, AZ 85044-7800
Phone
(480) 961-0014
Fax
(480) 961-0024
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2389 AZ Primary

Addresses

Primary practice location

13838 S 46TH PL
Suite 120
Phoenix, AZ 85044-7800

Mailing address

13838 S 46TH PL
Suite 120
Phoenix, AZ 85044-7800
Phone (480) 961-0014

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)
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
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206489600000",
    "number": "1962594861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13838 S 46TH PL",
            "address_2": "SUITE 120",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850447800",
            "telephone_number": "480-961-0014",
            "fax_number": "480-961-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13838 S 46TH PL",
            "address_2": "SUITE 120",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850447800",
            "telephone_number": "480-961-0014",
            "fax_number": "480-961-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORGESEN",
        "first_name": "PAUL",
        "name_suffix": "Jr.",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2008-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.

Verify at the official NPI Registry.