Blaise T Bourgeois, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1298341 Issued in TX

Practice address

9900 S Interstate 35 Ste P375
Austin, TX 78748-3885

Phone

(512) 580-3006

Fax

(512) 765-9192

NPI assigned

Aug 24, 2017

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

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Comeback Physical Therapy LLCGroup PAC ID 5395275564, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• BB Physiotherapy & Wellness

  • Physical Therapy Clinic/Center
  • Austin, TX
  • NPI 1396417291

  Physical Therapist

  Medicare reassignment NPD Authorized official
• Comeback Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Austin, TX
  • NPI 1538943204
  Medicare reassignment Care Compare group
• Agilitas USA Inc

  • Physical Therapy Clinic/Center
  • Hixson, TN
  • NPI 1962417444

  Physical Therapist, TX

  Medicare reassignment NPD
• Agilitas USA, Inc

  • Physical Therapy Clinic/Center
  • Chattanooga, TN
  • NPI 1518695436

  Physical Therapist

  NPD

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1497272017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306393",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372306393",
            "telephone_number": "615-373-1350",
            "fax_number": "615-221-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 S INTERSTATE 35 STE P375",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787483885",
            "telephone_number": "512-580-3006",
            "fax_number": "512-765-9192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURGEOIS",
        "first_name": "BLAISE",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1298341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Daniele Bouillion, AGNP-C
• Imane Boulares, LPC-ASSOCIATE
• Sallie Ann Boulos-Sophy, PHD
• Lisa Marie Meredith Bourbeau, DO
• Patricia Dolan Bouressa, LCSW
• Larisa Bourgeois, S.L.P.
• Sebastian Bourgeois, LPC
• Courtney Lynn Bourlon, LCSW
• Elise Boutin, MA, LPC ASSOCIATE
• Evelyn Amanda Boutot, PH.D.

• Physical Therapist in Austin, TX
• Providers in Austin, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.