Johane Gildade Boursiquot, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

277201 Issued in NY

Practice address

2015 Grand Concourse
Bronx, NY 10453-4303

Phone

(718) 299-7295

Fax

(718) 299-6797

NPI assigned

Dec 6, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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 Medicine

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 and National Provider Directory roles.

• Bronx Medical Practice P.C.

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1356726087
  Medicare reassignment NPD
• Essen Medical Associates, PC

  • Legal Medicine
  • Bronx, NY
  • NPI 1366418709
  Medicare reassignment NPD
• Essen Medical Urgicare, PLLC

  • Urgent Care Clinic/Center
  • Bronx, NY
  • NPI 1841607298
  Medicare reassignment NPD
• Hicksville Family Medical Care, PLLC

  • Family Medicine Physician
  • Mineola, NY
  • NPI 1770813792
  Medicare reassignment NPD
• House Call Medical Services of New York, PLLC

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1851345946
  Medicare reassignment NPD
• Island Urgent Care PLLC

  • Urgent Care Clinic/Center
  • East Meadow, NY
  • NPI 1376991414
  Medicare reassignment
• Essen Medical Associates, PC

  • Podiatrist
  • Bronx, NY
  • NPI 1720799158
  NPD
• Ny Family Medical Docs PC

  • Family Medicine Physician
  • Woodhaven, NY
  • NPI 1992204903
  NPD (past)

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

{
    "created_epoch": "1323129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1275801219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1436 WILLIAMSBRIDGE RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612507",
            "telephone_number": "718-618-0401",
            "fax_number": "347-479-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534303",
            "telephone_number": "718-299-7295",
            "fax_number": "718-299-6797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2015 Grand Concourse",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104534303",
            "country_code": "US",
            "telephone_number": "718-299-7295",
            "fax_number": "718-299-6797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7924 Jamaica Ave",
            "address_purpose": "LOCATION",
            "city": "Woodhaven",
            "state": "NY",
            "postal_code": "114211801",
            "country_code": "US",
            "telephone_number": "718-805-0037",
            "fax_number": "347-960-9468",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 Riverside Dr",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100242298",
            "country_code": "US",
            "telephone_number": "646-505-3500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "515 Madison Ave Ste 9083",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100225403",
            "country_code": "US",
            "telephone_number": "718-954-7338",
            "fax_number": "877-319-1942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOURSIQUOT",
        "first_name": "JOHANE",
        "middle_name": "GILDADE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-06",
        "last_updated": "2021-03-19",
        "certification_date": "2021-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT205076",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "277201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janelys Bourdier
• Berlyn Bourdierd
• Elisha Bouret
• Jenisse Bouret, CCC-SLP
• Larina Bourne
• Milena Boursiquot, MA
• Asmaa Bousserhane
• Ebbie Boutehsaz
• Ekaterini Boutos, RN, FNP
• John F Boutros, PA-C

• General Practice Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2021; 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.