Rebecca Lynn Bourbon, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

92-PA09 Issued in NM

Practice address

4005 High Resort Blvd SE
Rio Rancho, NM 87124-5906

Phone

(505) 462-6000

Fax

(505) 462-8472

NPI assigned

Jan 3, 2007

Last updated

Sep 10, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

88.68 of 100Reported as group

Quality

82.35

Promoting interoperability

100

Improvement activities

40

Cost

76.6

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://drchrono-fhirpresentation.everhealthsoftware.com/fhir/drchrono/504985/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Presbyterian Healthcare Services

  dba Presbyterian Medical Group

  • Internal Medicine Physician
  • Albuquerque, NM
  • NPI 1104802354
  Medicare reassignment NPD
• Presbyterian Healthcare Services

  dba Presbyterian Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1215913470
  NPD
• Presbyterian Healthcare Services

  dba Espanola Hospital

  • Rural Acute Care Hospital
  • Espanola, NM
  • NPI 1154307593
  NPD (past)
• Zia Internal Medicine Associates, LLC

  • Internal Medicine Physician
  • Santa Fe, NM
  • NPI 1194239145
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441843200000",
    "number": "1003973231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PRESBYTERIAN HEALTHCARE SERVICES",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 HIGH RESORT BLVD SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871245906",
            "telephone_number": "505-462-6000",
            "fax_number": "505-462-8472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURBON",
        "first_name": "REBECCA",
        "middle_name": "LYNN",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2015-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "92-PA09",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NM",
            "license": "92-PA09",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William A Borgeson, MD
• Erin Borrego, CPSW
• Bosque Clinic LLC (The Bosque Clinic)
• Bosque Mental Health
• Christopher Bouchard, MD
• Breanne Bower
• David Bowes
• Gary Alan Bowman, D.C.
• Joelle Lizette Bracken, LCSW
• Corey Alexander Bradley, R.PH.

• Physician Assistant in Rio Rancho, NM
• Providers in Rio Rancho, NM by specialty
• Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.