Individual provider Active NPI

Amanda Michelle Boroff, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1972139160
Registry record updated Mar 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11006499 Issued in FL
Practice address
4310 Metro Pkwy Ste 205
Fort Myers, FL 33916-9416
Phone
(239) 223-2751
NPI assigned
Mar 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11006499 FL Primary

Addresses

Primary practice location

4310 Metro Pkwy Ste 205
Fort Myers, FL 33916-9416

Mailing address

4310 Metro Pkwy Ste 205
Fort Myers, FL 33916-9416
Phone (239) 223-2751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200609001105 FL Practitioner - Nurse Practitioner 6204257751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dna Comprehensive Therapy Services LLCGroup PAC ID 2860619632, 446 clinicians

Practice addresses (Care Compare)

7623 Little Rd
Suite 300B
New Port Richey, FL 34654-5570
Phone (727) 910-5990

Merit-based Incentive Payment System (MIPS)

Final score
87.43 of 100Reported as group
Quality
74.02
Promoting interoperability
100
Improvement activities
40
Cost
77.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bonita Springs Retirement Village, Inc. CurrentSince Mar 30, 2020 Accepting new patients
Dna Comprehensive Therapy Services, LLC CurrentSince Mar 30, 2020 Accepting new patients

Locations

2721 Del Prado Blvd S
Ste 200
Cape Coral, FL 33904
Phone (239) 458-6677

418 SW 47th Ter
Cape Coral, FL 33914
Phone (239) 673-9034

4310 Metro Pkwy
Ste 205
Fort Myers, FL 33916

228 Plaza Dr
Ste D
Lehigh Acres, FL 33936
Phone (239) 491-8204

2230 Venetian Ct
Ste 1
Naples, FL 34109
Phone (239) 236-5448

7623 Little Rd
Ste 300B
New Port Richey, FL 34654
Phone (727) 910-5990

3191 Harbor Blvd
Ste B
Port Charlotte, FL 33952
Phone (941) 624-2141

3191 Harbor Blvd
Ste A
Pt Charlotte, FL 33952
Phone (941) 766-9555

5825 Argerian Dr
Ste 101
Wesley Chapel, FL 33545
Phone (813) 687-4870

Interoperability endpoints

  • Direct secure messaging: amanda.boroff.1@13142.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1972139160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 METRO PKWY STE 205",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339169416",
            "telephone_number": "239-223-2751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 METRO PKWY STE 205",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339169416",
            "telephone_number": "239-223-2751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOROFF",
        "first_name": "AMANDA",
        "middle_name": "MICHELLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-19",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11006499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.