Andrea Bourke, RPA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5643 Issued in CT

Practice address

1C Commons Dr Unit 16
Londonderry, NH 03053-3441

Phone

(603) 965-3551

Fax

(603) 818-8374

NPI assigned

Jul 23, 2012

Last updated

Sep 12, 2025By 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 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Physician Assistant

Education

New York College of Osteo Medicine of New York Institute of Technology, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairfield Dermatology P.C.Group PAC ID 9234201716, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Fairfield Dermatology, P.C.

  • Specialist
  • Fairfield, CT
  • NPI 1023295524
  Medicare reassignment Care Compare group
• Derry Dermatology, PLLC

  • Dermatology Physician
  • Londonderry, NH
  • NPI 1699036830
  NPD
• Dermatology and Skin Health LLC

  • Dermatology Physician
  • Peabody, MA
  • NPI 1184341562
  NPD
• Average Dermatology Nyc PC

  • MOHS-Micrographic Surgery Physician
  • New York, NY
  • NPI 1447126305
  NPD (past)
• Golden Age Dermatology PLLC

  • Dermatology Physician
  • New York, NY
  • NPI 1154871846
  NPD (past)
• Mickaela Marichal DNP Nurse Practitioner in Family Health PLLC

  • Nurse Practitioner
  • Jackson Heights, NY
  • NPI 1538074752
  NPD (past)
• Wainwright Dermatology, PLLC

  • Dermatology Physician
  • Cross River, NY
  • NPI 1457550352
  NPD (past)

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1194070466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "784 CENTRAL AVE",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202549",
            "telephone_number": "603-742-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1C COMMONS DR UNIT 16",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533441",
            "telephone_number": "603-965-3551",
            "fax_number": "603-818-8374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURKE",
        "first_name": "ANDREA",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-23",
        "last_updated": "2025-09-12",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "015768",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "5643",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NH",
            "license": "1660",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Christopher Bonneau Jr., FNP-BC
• Nicole Pauline Bouchard, LCMHC
• Raina Louise Bouchard, APRN
• Alyssa Boudreau
• Brianna Boulanger, APRN
• Jennifer Branson, APRN, FNP-C, WHNP-BC
• Sarah E Breau, PA-C
• Brennan Family Wellness LLC
• Bresnahan & Ball Counseling Services
• Sharon Parlee Bride, LPN

• Medical Physician Assistant in Londonderry, NH
• Providers in Londonderry, NH by specialty
• Medical Physician Assistant in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; 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.