Stacy L Bourgeois, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

649012 Issued in TX

Practice address

2411 Fountain View Dr
Houston, TX 77057-4832

Phone

(713) 620-4000

NPI assigned

Jan 8, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Compass Anesthesia Providers, PLLCGroup PAC ID 4082040878, 164 clinicians

Lone Star Anesthesia Associates, PLLCGroup PAC ID 2860882529, 25 clinicians

Specialized Crna Services LLCGroup PAC ID 1153544853, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Compass Anesthesia Providers PLLC

  • Anesthesiology Physician
  • Webster, TX
  • NPI 1669829750
  Medicare reassignment Care Compare group NPD
• Lone Star Anesthesia Associates, PLLC

  • Certified Registered Nurse Anesthetist
  • Houston, TX
  • NPI 1245801299

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Specialized Crna Services L.L.C.

  • Certified Registered Nurse Anesthetist
  • Houston, TX
  • NPI 1497186092

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Bahec LLC

  • Anesthesiology Physician
  • Webster, TX
  • NPI 1497079701
  Medicare reassignment NPD
• Anesthesia Dynamics LLC

  • Anesthesiology Physician
  • Bradenton, FL
  • NPI 1073001012

  Nurse Anesthetist, Certified Registered, TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435622400000",
    "number": "1619025533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 FOUNTAIN VIEW DR STE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770574832",
            "telephone_number": "713-620-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 FOUNTAIN VIEW DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770574832",
            "telephone_number": "713-620-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURGEOIS",
        "first_name": "STACY",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2015-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA3122",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "649012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "86993U",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "185860701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00396099",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremy Bourgeois, PT, DPT
• Keith Alan Bourgeois, M.D.
• Kelly Bourgeois, M.D.
• Kendralyn Bourgeois, LPC-A
• Robert Scott Bourgeois, CRNA
• Warner Bourgeois, LPC
• Lisa Bourgoyne, LPC
• Bjorg Tuppen Bourianoff, OT
• Abigail Bourland, MD
• Stacey L Bourland, PH.D

• Certified Registered Nurse Anesthetist in Houston, TX
• Providers in Houston, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; 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.