Bryan Clark Bordeaux, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

231683 Issued in MA

Practice address

165 Dartmouth St
Internal Medicine
Boston, MA 02116-5123

Phone

(617) 859-5101

Fax

(617) 859-5050

NPI assigned

Apr 27, 2006

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MA

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 1

Specialty

Internal Medicine

Education

Philadelphia College of Osteopathic Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mass General Brigham Home Care, Inc Home health agency, Newton, MA, CCN 227207
• Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Atrius Health, Inc.

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1871639914
  Medicare reassignment Care Compare group NPD
• Atrius Health, Inc.

  dba Harvard Vanguard Medical Associates

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1841413887
  NPD
• Atrius Health, Inc.

  dba Harvard Vanguard Medical Associates

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1740238526
  NPD (past)

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

• Mass General Brigham Home Care, Inc.

  dba Partners Healthcare At Home - Home Care

  • Home Health Agency
  • Newton, MA
  • NPI 1083644017
  Care Compare affiliation Name & address match
• Beth Israel Deaconess Medical Center, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1548202641
  Care Compare affiliation

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1972560696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 DARTMOUTH ST",
            "address_2": "INTERNAL MEDICINE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165123",
            "telephone_number": "617-859-5101",
            "fax_number": "617-859-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 DARTMOUTH ST",
            "address_2": "INTERNAL MEDICINE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165123",
            "telephone_number": "617-859-5101",
            "fax_number": "617-859-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDEAUX",
        "first_name": "BRYAN",
        "middle_name": "CLARK",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "H62994",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "231683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2151383",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bbordeauxmd19223@direct.atrius.masshiway.net",
            "affiliation": "N",
            "address_1": "165 Dartmouth St",
            "address_2": "Internal Medicine",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021165123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John Simmons Borchert, MS
• Pierre Borczuk, MD
• Rachel Borczuk
• Cecilia Heddy Borda Bossana, DDS
• Darius Dustin Bordbar, MD
• Aja Star Borden, LPN
• Brittany Alyssa Borden, MD
• Jonathan Borden, MD
• Stacey K. Borden, M.ED., LADC-1
• Emily Joy Borders, DPT

• Internal Medicine Physician in Boston, MA
• Providers in Boston, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; 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.