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ETHAN ALEKSANDR BORK DO
NPI 1073204665
Psychiatry & Neurology - Psychiatry in Dearborn, MI

Active since May 16, 2023PECOS Enrolled
18101 OAKWOOD BLVD, DEARBORN, MI 48124(313) 593-7000 Get Directions Write a Review

NPPES record last updated: May 16, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Ethan Aleksandr Bork Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHAN ALEKSANDR BORK DO (NPI 1073204665) is an individual psychiatry provider in Dearborn, Michigan, licensed in Michigan (5151016273APP23) and active in the NPI registry since May 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073204665
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameETHAN ALEKSANDR BORKCredential: DO
Location Address18101 OAKWOOD BLVDDearborn, MI 48124-4089
Mailing Address15039 Harrison AveAllen Park, MI 48101-1806 · (313) 613-9233
Phone(313) 593-7000
Sole ProprietorNo
Enumeration DateMay 16, 2023
NPPES CertifiedMay 15, 2023
✔ NPI 1073204665 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in MI · 5151016273APP23
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
18101 OAKWOOD BLVD, Dearborn, MI 48124
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ethan Aleksandr Bork Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Ethan Bork reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

The Mel Bornstein Clinic For Psychoanalysis And Psychotherapy
18 mi
Multi-Specialty
32841 MIDDLEBELT RD STE 403
Farmington Hills, MI 48334
  • Reassigned Medicare billing, Michigan enrollment
  • 31 clinicians in this Medicare group
NPI 1023546389 (248) 910-0315

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48124 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$177.36 typical visit price
range $58.04 – $177.36
Typical copayment $44.34 (range $14.51 – $44.34)
Most-billed visit code 99205
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MEGAN NICOLE SANBORN CRNA
Nurse Anesthetist, Certified Registered
18101 OAKWOOD BLVD
DEARBORN, MI 48124
Wayne County (313) 436-2374
DR. MATTHEW JOSEPH HUNT DO
Surgery
18101 OAKWOOD BLVD
DEARBORN, MI 48124
Wayne County (313) 593-7000
OAKWOOD AMBULATORY LLC
Internal Medicine
18101 OAKWOOD BLVD
DEARBORN, MI 48124
Wayne County (313) 593-7000
MICHAEL KROLL CRNA
Nurse Anesthetist, Certified Registered
18101 OAKWOOD BLVD, ANESTHESIA DEPT
DEARBORN, MI 48124
Wayne County (313) 593-7820
DR. NEHA DESAI PHARM.D.
Pharmacist (Pharmacotherapy)
18101 OAKWOOD BLVD, PHARMACY
DEARBORN, MI 48124
Wayne County (313) 593-7268
DR. ROHAN LALITH DERANIYAGALA M.D.
Radiology (Radiation Oncology)
18101 OAKWOOD BLVD
DEARBORN, MI 48124
Wayne County (248) 551-5490
KIA SWEENEY
Psychiatry & Neurology (Psychiatry)
18101 OAKWOOD BLVD
DEARBORN, MI 48124
Wayne County (947) 522-3088
JESSICA FLINT MD
Obstetrics & Gynecology
18101 OAKWOOD BLVD
DEARBORN, MI 48124
Wayne County (313) 436-2582

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Bork's NPI number?

The NPI number for Ethan Bork is 1073204665. It was assigned to this individual provider in the NPPES registry on May 16, 2023.

Where is Ethan Bork located?

Ethan Bork practices at 18101 Oakwood Blvd, Dearborn, MI 48124. The listed phone number is (313) 593-7000.

What is Ethan Bork's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Ethan Bork enrolled in Medicare?

Yes. Ethan Bork is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Ethan Bork's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ethan Bork reassigns Medicare benefits to The Mel Bornstein Clinic For Psychoanalysis And Psychotherapy (Farmington Hills, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ethan Bork's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Ethan Bork was last updated on May 16, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.