Individual provider

Kelly Borgman, O.D.

Pediatric Optometrist Optometrist Medicare enrolled

Kelly Borgman, O.D. is a provider specialising in Pediatric Optometrist in Holland, MI, registered under NPI 1063759678. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.

Getting there

The practice address on file is 904 WASHINGTON AVE STE 120, Holland, MI 49423. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

904 WASHINGTON AVE STE 120, Holland, MI 49423 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
4901005784 MI Pediatric Optometrist primary
1910DT KY Optometrist
1910DT KY Pediatric Optometrist

Licences are recorded in 2 states: MI, KY. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Optometry
PAC ID
8022353499

Medicare enrolment is recorded as approved under the provider type Practitioner - Optometry. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

Licensed in 2 states

This provider holds licences in 2 states: Kentucky and Michigan. The practice address on file is in Holland, MI, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

KY Kentucky
Licence
1910DT
Specialty
Optometrist
Verify with the KY board →
MI Michigan practice address
Licence
4901005784
Specialty
Pediatric Optometrist
Verify with the MI board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What Pediatrics covers

Optometrists who work in Pediatrics are concerned with the prevention, development, diagnosis, and treatment of visual problems in children. NUCC Health Care Provider Taxonomy, code 152WP0200X
Eye and Vision Services Providers Optometrist Pediatrics

All registered taxonomy codes

This provider registers 3 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
152WP0200X Pediatric Optometrist Pediatrics 4901005784 MI primary
152W00000X Optometrist 1910DT KY
152WP0200X Pediatric Optometrist Pediatrics 1910DT KY

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1063759678 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateJan 16, 2013
Last updatedAug 20, 2025
StatusActive
Sole proprietorNo
CredentialO.D.
Practice address 904 WASHINGTON AVE STE 120
Holland, MI 49423
(616) 796-9995
This record was updated on Aug 20, 2025, which is recent enough that the contact details are likely still accurate.

Number check

1063759678 passes the NPI check digit test The final digit 8 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 0 6 3 7 5 9 6 7
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 0 3 3 5 5 9 6 5

Sum = 62 · next multiple of 10 = 70 · check digit = 8 · actual last digit = 8

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1063759678?
NPI 1063759678 is the National Provider Identifier assigned to Kelly Borgman, O.D. in Holland, MI. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Pediatrics cover?
Optometrists who work in Pediatrics are concerned with the prevention, development, diagnosis, and treatment of visual problems in children.
How do I contact Kelly Borgman, O.D.?
The phone number on file with NPPES is (616) 796-9995, last updated Aug 20, 2025. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Kelly Borgman, O.D. accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1063759678 a valid number?
Yes. 1063759678 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.