Rae Lindsay Bourne, M.D.
Individual provider Active NPI Rheumatology Physician · Orinda, CA
NPI 1356569628 · NPPES record last updated Feb 11, 2022
Key facts
- NPI
- 1356569628
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Rheumatology Physician 207RR0500X
- License
- A94483 (CA)
- Practice address
- 21 Orinda Way
Suite C, PMB 276
Orinda, CA 94563-2530 - Phone
- (925) 257-2896
- Fax
- (925) 913-7044
- NPI assigned
- Apr 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 7
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Rheumatology
- Education
- Howard University College of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Permanente Medical Group Inc
Practice addresses (Care Compare)
975 Sereno Dr
Vallejo, CA 94589-2441
Phone (707) 651-1000
99 Montecillo Rd
San Rafael, CA 94903-3308
Phone (415) 444-2000
Hospital & facility affiliations
- Kaiser Foundation Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081008000437 | CA | Practitioner - Rheumatology |
7810983715 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006-00114 | NC | MD | Internal Medicine Physician |
| A94483 | CA | MD | Rheumatology Physician |
| 001915 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Permanente Medical Group Inc | Internal Medicine | Current | Accepting new patients |
| Permanente Medical Group, Inc | Current |
Accepting new patients | |
| Permanente Medical Group Inc | Internal Medicine | Current |
Accepting new patients |
| Ronald G Connolly MD | Rheumatology | Past | Accepting new patients |
| Staten Island Hospitalists, PC | Internal Medicine | Past | Accepting new patients |
| Richard P Carr Physical Therapy Inc | Past | Accepting new patients |
Locations
1800 Harrison St
Fl 7
Oakland, CA 94612
1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015
901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500
2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000
99 Montecillo Rd
San Rafael, CA 94903
Phone (415) 444-2047
710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400
7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000
975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2006-00114 | NC | |
| Internal Medicine Physician | 207R00000X | 235755 | NY | |
| Internal Medicine Physician | 207R00000X | A94483 | CA | |
| Rheumatology Physician | 207RR0500X | A94483 | CA | Yes |
Addresses
Primary practice location
21 Orinda Way
Suite C, PMB 276
Orinda, CA 94563-2530
Mailing address
21 Orinda Way
Suite C, PMB 276
Orinda, CA 94563-2530
Phone (925) 257-2896
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A94483 | Other | CA | CALIFORNIA LICENCE |
| 1356569628 | Other | NPI NUMBER |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
Other providers in Orinda, CA
- Scott Belshaw
- Lisa M. Belvy
- Ryan James Berardi
- Lia Osunfunlayo Blaustein
- Istvan Borocz
- James Howard Bramson
- Kenneth Allen Breslin
- Michelle D. Bricker
- Alison Fearon Brouillard
- Marie Madeleine Burkhart
All providers in Orinda, CA · Rheumatology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.