Stephen John Bourgault, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2887 Issued in MA

Practice address

61 Fox St
Fitchburg, MA 01420-3235

Phone

(978) 342-7147

Fax

(978) 345-3567

NPI assigned

Aug 30, 2005

Last updated

Jul 13, 2026By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1407849029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 FOX ST",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014203235",
            "telephone_number": "978-342-7147",
            "fax_number": "978-345-3567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 FOX ST",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014203235",
            "telephone_number": "978-342-7147",
            "fax_number": "978-345-3567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURGAULT",
        "first_name": "STEPHEN",
        "middle_name": "JOHN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "2887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9783814",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra Lynne Boucher, RN
• Gail Louise Boucher
• Samantha Lee Boucher, RN
• Michelle Boudreau, NP-C
• Nance Anne Boudreau, MA
• Amanda Bourque
• Diane S Bouvier
• Zaira Owen Boylan, MA
• Dennis Anthony Bradley Sr., PSYCHOTHERAPIST
• Mark Edward Bradley, CLINICIAN

• Optometrist in Fitchburg, MA
• Providers in Fitchburg, MA by specialty
• Optometrist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.