Brenda Bourassa, DO

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

OS7548 Issued in FL

Practice address

407 SE 9TH St
Suite 103
Fort Lauderdale, FL 33316-1113

Phone

(954) 463-0112

Fax

(954) 463-0117

NPI assigned

Sep 2, 2006

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15644/brand/1/csg/1/fhir/r4

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.

• Florida Kidney Physicians, LLC

  • Nephrology Physician
  • Temple Terrace, FL
  • NPI 1760831564
  Medicare reassignment NPD
• Florida Kidney Physicians , LLC

  • Nephrology Physician
  • Melbourne, FL
  • NPI 1205506722
  NPD

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1184726978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 SE 9TH ST",
            "address_2": "SUITE 103",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333161113",
            "telephone_number": "954-463-0112",
            "fax_number": "954-463-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 SE 9TH ST",
            "address_2": "SUITE 103",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333161113",
            "telephone_number": "954-463-0112",
            "fax_number": "954-463-0117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURASSA",
        "first_name": "BRENDA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "OS7548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273027800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa A Bottge
• Kara Botti
• David Lee Botton, LIC. A.P.
• Daniela Bou Daher Rachwan
• Kaidian Boubacar, MSW
• France Bourget, OBGYN, M.D
• Mehdi Bouslama
• Bout Me Healing
• Kathleen Bouyett, APRN
• Martha Bouza, M.D.

• Nephrology Physician in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Nephrology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; 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.