Individual provider Active NPI

Robin F Borchardt, M.D.

  • Family Medicine Physician
  • Rockford, IL
National Provider Identifier
1992734297
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036073282 Issued in IL
Practice address
5875 E Riverside Blvd
Rockford, IL 61114
Phone
(815) 398-9491
Fax
(815) 381-7498
NPI assigned
Jul 1, 2006
Last updated
Dec 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 036073282 IL
Family Medicine Physician 207Q00000X 036073282 IL Primary
Adult Medicine Physician 207QA0505X 036073282 IL
Occupational Medicine Physician 2083X0100X 036073282 IL

Addresses

Primary practice location

5875 E Riverside Blvd
Rockford, IL 61114

Mailing address

5012 Talaton St
Loves Park, IL 61111-3481
Phone (815) 608-0991

Other identifiers 3

IdentifierTypeStateIssuer
F400279810OtherILMEDICARE
F400480164OtherILMEDICARE
036073282MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Borchardt.Robin@ro.eclinicaldirect.com Direct

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
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Immediate Care LTD Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: borchardt.robin@ro.eclinicaldirect.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1992734297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5012 TALATON ST",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611113481",
            "telephone_number": "815-608-0991",
            "fax_number": "815-381-7498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5875 E RIVERSIDE BLVD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61114",
            "telephone_number": "815-398-9491",
            "fax_number": "815-381-7498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORCHARDT",
        "first_name": "ROBIN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "IL",
            "license": "036073282",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036073282",
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "IL",
            "license": "036073282",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "IL",
            "license": "036073282",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "F400279810",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "F400480164",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036073282",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Borchardt.Robin@ro.eclinicaldirect.com",
            "affiliation": "N",
            "endpointDescription": "eCW email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5875 E Riverside Blvd",
            "city": "Rockford",
            "state": "IL",
            "country_code": "US",
            "postal_code": "61114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.