Individual provider Active NPI

Aidan L Bourbonnais, PAC

  • Surgical Physician Assistant
  • Hyannis, MA
National Provider Identifier
1053223495
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
130 North St
Hyannis, MA 02601-3825
Phone
(508) 775-8282
NPI assigned
Sep 21, 2026
Last updated
Sep 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X MA Primary

Addresses

Primary practice location

130 North St
Hyannis, MA 02601-3825

Mailing address

130 North St
Hyannis, MA 02601-3825
Phone (508) 775-8282

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1789948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1053223495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 NORTH ST",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026013825",
            "telephone_number": "508-775-8282",
            "fax_number": "508-775-8280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 NORTH ST",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026013825",
            "telephone_number": "508-775-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURBONNAIS",
        "first_name": "AIDAN",
        "middle_name": "L",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-21",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyannis, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.