| NPI | 1174772354 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2008-09-12 |
| Last Updated | 2023-06-14 |
| Mailing Address | 6210 E Hwy 290 Ste 240 Austin, TX 78723-1144 United States Phone: (512) 483-9596 | Fax: (512) 406-6216 📍 View Map |
| Primary Practice Address | 11714 Wilson Parke Ave Ste 150 Austin, TX 78726-4061 United States Phone: (737) 247-7200 | Fax: (512) 406-7368 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | TX | 319331001 | - |
| Other (non-Medicare) | TX | P01331818 | RRMC |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 2084N0400X – Psychiatry & Neurology, Neurology | TX | P5598 |
| No | 207R00000X – Internal Medicine | MA | 236439 |
| No | 390200000X – Student in an Organized Health Care Education/Training Program | MA | 236439 |
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About NPI 1174772354
Scott A Boruchow M.D. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1174772354. The primary specialty listed is Psychiatry & Neurology, Neurology. The provider is located in Austin, TX. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2008-09-12. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1174772354?
NPI 1174772354 belongs to Scott A Boruchow M.D., a Psychiatry & Neurology, Neurology in Austin, TX. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1174772354 active?
The current status of NPI 1174772354 in the NPPES registry is Active. The record was last updated on 2023-06-14.
What specialty is NPI 1174772354?
NPI 1174772354 is classified under the taxonomy Psychiatry & Neurology, Neurology. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1174772354?
You can verify NPI 1174772354 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1174772354?
The primary practice address on file for NPI 1174772354 is 11714 Wilson Parke Ave Ste 150, Austin, TX 78726-4061. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1174772354 issued?
NPI 1174772354 was first issued (enumerated) on 2008-09-12. The NPPES record was last updated on 2023-06-14.
Practice Location Map
Scott A Boruchow is located at 11714 Wilson Parke Ave Ste 150, Austin, TX. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Scott A Boruchow. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1174772354. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Psychiatry & Neurology, Neurology | P5598 | TX |
| Internal Medicine | 236439 | MA |
| Student in an Organized Health Care Education/Training Program | 236439 | MA |