Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Ivan Borissow, PA-C

Individual provider Physician Assistant · NPI 1194080374

Mr. Ivan Borissow, PA-C is a Physician Assistant in Baltimore, Maryland. Qualified in 2012, 14 years ago. Practices with Medstar Medical Group II LLC, a 3,717-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Maryland.

Years since qualifying
14
Licensed in
MD
In the registry since
2012
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

5601 Loch Raven Blvd
Baltimore, MD 21239-2945
Phone: (443) 444-8000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4940 Eastern Ave Bldg 5w, Baltimore, MD 21224-2735 — (410) 550-0942

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence C04854 (MD)

Record details

NPI number1194080374
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 12, 2012
Last updated in NPPESMay 11, 2020
Certification dateMay 11, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Medstar Medical Group Ii Llc — 3717 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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