Cheryl R Bourgault, PA C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA152468 Issued in OR

Practice address

360 S Garden Way
Suite 210
Eugene, OR 97401-8173

Phone

(541) 683-3202

Fax

(541) 868-1063

NPI assigned

Oct 6, 2005

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 OR

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

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Diane L Baird MD PCGroup PAC ID 7810988565, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.57 of 100Reported as group

Quality

87.14

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Diane L Baird MD PC

  • Dermatology Physician
  • Eugene, OR
  • NPI 1750447546
  Medicare reassignment Care Compare group
• David L. Lukens,D.O.,P.S.

  • Family Medicine Physician
  • Tacoma, WA
  • NPI 1265765309
  NPD (past)
• Northwest Family & Spinal Clinic Inc PS

  • Family Medicine Physician
  • Tacoma, WA
  • NPI 1548357098
  NPD (past)

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1205823036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 S GARDEN WAY STE 210",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974018186",
            "telephone_number": "541-683-3202",
            "fax_number": "541-868-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 S GARDEN WAY",
            "address_2": "SUITE 210",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974018173",
            "telephone_number": "541-683-3202",
            "fax_number": "541-868-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURGAULT",
        "first_name": "CHERYL",
        "middle_name": "R",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-06",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA152468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500666195",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janet Ann Bott
• Leah Bott, OTR
• Theresa Marie Boudreau
• Kara Nystrom Boulahanis, MAT, QMHP
• Sayuri Grace Boullester
• Kayla Ann Bourgault
• Donna Marie Bouthillier, LMT
• Marc Bouvier
• David A. Bove, N.D., L.AC.
• Douglas Lee Bovee, MD

• Physician Assistant in Eugene, OR
• Providers in Eugene, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.