Steven Bourla, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

128336 Issued in NY

Practice address

789 Old Country Rd
Plainview, NY 11803-4907

Phone

(516) 433-3600

Fax

(516) 433-9490

NPI assigned

Jun 21, 2006

Sex

Male

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 NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Island Medical Group, PC

  • Internal Medicine Physician
  • Bethpage, NY
  • NPI 1285748749
  NPD
• Optum Urgent Care, PLLC

  • Urgent Care Clinic/Center
  • Jericho, NY
  • NPI 1285975797
  NPD (past)

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361491200000",
    "number": "1649216367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4277 HEMPSTEAD TPKE",
            "address_2": "SUITE 209",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117145709",
            "telephone_number": "516-731-7770",
            "fax_number": "516-731-7052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 OLD COUNTRY RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118034907",
            "telephone_number": "516-433-3600",
            "fax_number": "516-433-9490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURLA",
        "first_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2013-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "128336",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "128336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00887036",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "AS530",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "1C4996",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marissa Bonasia-Solis, CCC-SLP
• Sara Bondar
• Mary J. Borcherding, M.A., CCC-SLP, TSSLD
• Diana Catherine Borowski, LMSW
• Kimberly Bourke, CCC-SLP
• Giavonna Bovino
• Bridget Boyke
• Ruth Frances Brachman
• Charlotte Bracken, MSOT
• Lea Bram, DDS

• Nephrology Physician in Plainview, NY
• Providers in Plainview, NY by specialty
• Nephrology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.