Nicholas James Bournias, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2901015573 Issued in MI

Practice address

43900 Garfield Rd Ste 103
Clinton Township, MI 48038-1137

Phone

(586) 228-9070

NPI assigned

Nov 16, 2005

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 4

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Maxillofacial Surgery

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michigan Oms P CGroup PAC ID 9739084559, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nbournia@direct.dmc.org
• Direct secure messaging: nbournias1118345@direct.hfhs.org

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

• Michigan Oms P C

  • Oral and Maxillofacial Surgery (Dentist)
  • West Bloomfield, MI
  • NPI 1801906458
  Medicare reassignment Care Compare group NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• William Beaumont Hospital

  • General Acute Care Hospital
  • Troy, MI
  • NPI 1306825997
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Royal Oak, MI
  • NPI 1689653305
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Grosse Pointe, MI
  • NPI 1932396017
  Care Compare affiliation

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1144202045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 S DEEPLANDS RD",
            "city": "GROSSE POINTE SHORES",
            "state": "MI",
            "postal_code": "482362642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43900 GARFIELD RD STE 103",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381137",
            "telephone_number": "586-228-9070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURNIAS",
        "first_name": "NICHOLAS",
        "middle_name": "JAMES",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901015573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3203473",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "NB015573",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3159052",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "970F31085",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sabrina Bossio, PHARMD
• Karla Boswell
• Ava Noel Bothel
• Kyle James Bott
• Sarah Bouali
• Samantha Boutin, LMSW
• Mary Bowers
• Rebecca Bowman
• Regina Boyd, P.T.A.
• Janice Gail Brackenbury, PTA

• Oral and Maxillofacial Surgery (Dentist) in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; 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.