Jason Bourque, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

307858 Issued in LA

Practice address

120 Rue Louis Xiv
Lafayette, LA 70508-5739

Phone

(337) 769-7779

NPI assigned

May 7, 2009

Last updated

Mar 17, 2018By 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 3

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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

Urology

Education

Louisiana State University School of Medicine in New Orleans, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Urology LLCGroup PAC ID 5597833772, 27 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Nursing Specialties Home health agency, Lafayette, LA, CCN 197297
• Ochsner Lafayette General Medical Center Hospital, Lafayette, LA, CCN 190002
• Acadia General Hospital Hospital, Crowley, LA, CCN 190044
• Our Lady of Lourdes Regional Medical Center, Inc Hospital, Lafayette, LA, CCN 190102
• Ochsner American Legion Hospital Hospital, Jennings, LA, CCN 190053
• Park Place Surgical Hospital Hospital, Lafayette, LA, CCN 190255

Merit-based Incentive Payment System (MIPS)

Final score

93.2 of 100Reported as group

Promoting interoperability

92

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jasonbourque@southernuro.medalliesdirect.net

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.

• Southern Urology, LLC

  • Urology Physician
  • Lafayette, LA
  • NPI 1740441955
  Medicare reassignment Care Compare group NPD
• Southern Urology LLC

  • Urology Physician
  • Opelousas, LA
  • NPI 1386352151
  NPD
• Scott & White Hospital - Taylor

  dba Baylor Scott & White Medical Center - Taylor

  • Emergency Medicine Physician
  • Taylor, TX
  • NPI 1659366557
  NPD (past)

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

• Acadia General Hospital, Inc.

  dba Acadia General Hospital

  • General Acute Care Hospital
  • Crowley, LA
  • NPI 1669882940
  Care Compare affiliation
• Lafayette General Medical Center Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1275536799
  Care Compare affiliation
• Nsi, Inc.

  • Home Health Agency
  • Lafayette, LA
  • NPI 1528138112
  Care Compare affiliation
• Ochsner American Legion Hospital LLC

  dba Ochsner American Legion Hospital

  • General Acute Care Hospital
  • Jennings, LA
  • NPI 1184373268
  Care Compare affiliation
• Our Lady of Lourdes Regional Medical Center, Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1598766495
  Care Compare affiliation
• Park Place Surgery Center, LLC

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1215996632
  Care Compare affiliation

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

{
    "created_epoch": "1241654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1205060175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 RUE LOUIS XIV",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085739",
            "telephone_number": "337-769-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 RUE LOUIS XIV",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085739",
            "telephone_number": "337-769-7779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Beaullieu Dr Ste 7",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705087230",
            "country_code": "US",
            "telephone_number": "337-233-2455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2401 S 31st St",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "765080001",
            "country_code": "US",
            "telephone_number": "254-724-2111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOURQUE",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TX",
            "license": "10033777",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TX",
            "license": "Q3854",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "LA",
            "license": "307858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trysten Theresa Bourgeois, BS, HS
• Janna Mae Bourque Cardona
• Daniel R Bourque, MD
• Emily Bourque, RD, LD
• Hannah Gabrielle Bourque, DDS
• Jessie Bourque, CRNP
• Jodie Marie Duhon Bourque, CRNA
• Jordan Bourque, PT
• Latasha Chantella Bourque, BSN, RN
• Thad Alexander Bourque, MD

• Urology Physician in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Urology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.