Harvey Bouru

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601009896 Issued in MI

Practice address

1770 Fort St
Lincoln Park, MI 48146-1904

Phone

(313) 753-0016

NPI assigned

Jun 16, 2020

Sex

Male

Sole proprietor

Yes

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 MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

University of Toledo College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novahealth Urgent Care of SouthfieldGroup PAC ID 3678933520, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Novahealth Urgent Care of Southfield

  • Urgent Care Clinic/Center
  • Southfield, MI
  • NPI 1841975620
  Medicare reassignment Care Compare group Authorized official
• Get Well Urgent Care Downriver PLC

  • Urgent Care Clinic/Center
  • Lincoln Park, MI
  • NPI 1578035317
  Medicare reassignment
• Southshore Urgent Care PLLC.

  • Urgent Care Clinic/Center
  • Brownstown TWP, MI
  • NPI 1356804710
  Medicare reassignment
• Wyandotte Urgent Care Clinic

  • Urgent Care Clinic/Center
  • Wyandotte, MI
  • NPI 1316467384
  Medicare reassignment
• Blue Water Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Fort Gratiot, MI
  • NPI 1477135036
  NPD (past)

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1518582485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5346 CLIPPERT ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481252740",
            "telephone_number": "313-753-0016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 FORT ST",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481461904",
            "telephone_number": "313-753-0016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURU",
        "first_name": "HARVEY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-16",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601009896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonafide Care PLLC
• Florine Bond, LMSW
• Gary M Bonior, D.D.S.
• Bormans Inc
• Alexander Boskovic III
• Heidi Bremer, LLBSW
• Ryan Bright
• Pamela Marie Brown
• Viktor Lane Brown, PHD
• Tiawna Michelle Bryant, REGISTERED NURSE

• Physician Assistant in Lincoln Park, MI
• Providers in Lincoln Park, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; 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.