Look up the most recent NPI and PECOS records

Brian Bourgeault

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

Based on the most recent information from CMS, provider Brian Bourgeault is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1962651604
Provider Type
Individual
Full Name
Bourgeault, Brian
Credential
PA

Gender
Male
Sole Proprietor
No
Enumeration Date
9/18/2008
Last Updated
3/17/2011

Contact Information

Practice Location

140 High St, Springfield, MA 01199-1006

(413) 794-2511

Unlisted Fax

Mailing Location

280 Chestnut St, 2nd Floor, Springfield, MA 01199-1000

(413) 794-5700

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363AM0700X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 2603 Massachusetts

Brian Bourgeault

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Dudley, Catherine R

Meckel, Marie

Paddleford, Bonnie H

Binnall, Kelly M

Foster, Bethany B.

Albano, Katelyn

Fisher, Rebecca A

Acholonu, Ezra

Simon, William

Sebastyn, Lisa A