Mark A Bourcier, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21201 Issued in MA

Practice address

391 Montgomery St
Chicopee, MA 01020-1929

Phone

(413) 592-8099

Fax

(513) 592-5839

NPI assigned

Apr 3, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Wegrzyn Dental Group Inc

  • General Practice Dentistry
  • Chicopee, MA
  • NPI 1487788204
  NPD (past)

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093836017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 MONTGOMERY ST",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010201929",
            "telephone_number": "413-592-8099",
            "fax_number": "513-592-5839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 MONTGOMERY ST",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010201929",
            "telephone_number": "413-592-8099",
            "fax_number": "513-592-5839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURCIER",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1426492",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1426492",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MASS",
            "identifier": "X11395",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace Lauren Bono
• Andrea Personis Boraski, DMD
• Courtney Bordo, MSN, CNP, PMHNP-BC
• Anna Bouchard
• Deborah A Boulanger, LMT
• Sean Bourgeoise, MA
• Kelsey Bouthilette, OTR/L
• Luz Bowler, LCSW
• Lisa Marteki Boye, NP
• Stephanie Marie Bradt

• General Practice Dentistry in Chicopee, MA
• Providers in Chicopee, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.