Lisa Marie Meredith Bourbeau, DO

Primary specialty

Obstetrics PhysicianTaxonomy code 207VX0000X

License

U3794 Issued in TX

Practice address

11111 Research Blvd
Austin, TX 78759-5264

Phone

(512) 324-6000

Fax

(512) 406-7348

NPI assigned

Mar 21, 2019

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

Medicare fee-for-service enrollment

Enrolled in TX

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

Obstetrics/Gynecology

Education

At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Austin Regional Clinic PAGroup PAC ID 3072507789, 398 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Seton Northwest Hospital, Austin, TX, CCN 450867

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lbbourbeau28350@arcmd.direct-ci.com

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.

• Austin Regional Clinic, PA

  • Family Medicine Physician
  • Austin, TX
  • NPI 1821157579
  Medicare reassignment Care Compare group NPD
• Austin Regional Clinic, PA

  • Durable Medical Equipment & Medical Supplies
  • Kyle, TX
  • NPI 1235746413
  NPD
• Ascension Seton

  • General Acute Care Hospital
  • Austin, TX
  • NPI 1124137054
  NPD (past)

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

• Ascension Seton

  • General Acute Care Hospital
  • Austin, TX
  • NPI 1124137054
  Care Compare affiliation

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

{
    "created_epoch": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1376003764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 E HWY 290",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787231142",
            "telephone_number": "512-483-9596",
            "fax_number": "512-406-6216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11111 RESEARCH BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787595264",
            "telephone_number": "512-324-6000",
            "fax_number": "512-406-7348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURBEAU",
        "first_name": "LISA",
        "middle_name": "MARIE MEREDITH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-21",
        "last_updated": "2023-08-04",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "TX",
            "license": "U3794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naima Melisa Boudreaux, LPC-A
• Sara Bouffard, PA-C
• Lisa Daniele Bouillion, AGNP-C
• Imane Boulares, LPC-ASSOCIATE
• Sallie Ann Boulos-Sophy, PHD
• Patricia Dolan Bouressa, LCSW
• Blaise T Bourgeois, PT, DPT
• Larisa Bourgeois, S.L.P.
• Sebastian Bourgeois, LPC
• Courtney Lynn Bourlon, LCSW

• Obstetrics Physician in Austin, TX
• Providers in Austin, TX by specialty
• Obstetrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.