Adam Labree Bourgon, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

02004369A Issued in IN

Practice address

633D Medical Group
77 Nealy Ave
Joint Base Langley-Eustis, VA 23665-2040

Phone

(757) 764-6950

NPI assigned

Apr 17, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, WI, SD3 enrollments

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 3

Specialty

General Surgery

Education

University of New England, College of Osteo Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sanford Health NetworkGroup PAC ID 6800707100, 357 clinicians

Aspirus Riverview Hospital and Clinics IncGroup PAC ID 4587658182, 166 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sanford Medical Center Aberdeen Hospital, Aberdeen, SD, CCN 430097
• Aspirus Riverview Hospital & Clinics Inc Hospital, Wisconsin Rapids, WI, CCN 520033

Merit-based Incentive Payment System (MIPS)

Final score

90.65 of 100Reported as group

Quality

87.9

Promoting interoperability

100

Improvement activities

40

Cost

73.87

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: abourgon163238@direct.aspirus.org

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.

• Aspirus Riverview Hospital & Clinics, Inc.

  • General Acute Care Hospital
  • Wisconsin Rapids, WI
  • NPI 1295754844

  WI

  Medicare reassignment Care Compare group NPD
• Riverside Physician Services Inc

  • Gastroenterology Physician
  • Newport News, VA
  • NPI 1194929026

  VA

  Medicare reassignment NPD
• Aspirus Stevens Point Hospital & Clinics, Inc.

  • General Acute Care Hospital
  • Stevens Point, WI
  • NPI 1538112230

  WI

  Medicare reassignment NPD
• Aspirus Riverview Hospital & Clinics, Inc.

  • Rural Health Clinic/Center
  • Marshfield, WI
  • NPI 1124633870
  Care Compare group NPD
• Sanford Health Network

  • Critical Access Hospital
  • Vermillion, SD
  • NPI 1790721280

  SD

  Medicare reassignment
• Aspirus Riverview Hospital & Clinics, Inc.

  • Rural Health Clinic/Center
  • Nekoosa, WI
  • NPI 1104284512
  Care Compare group
• Aspirus Riverview Hospital & Clinics, Inc.

  • Multi-Specialty Clinic/Center
  • Adams, WI
  • NPI 1114411287
  Care Compare group
• Aspirus Riverview Hospital & Clinics, Inc.

  • Rural Health Clinic/Center
  • Wisconsin Rapids, WI
  • NPI 1184176059
  Care Compare group
• Aspirus Riverview Hospital & Clinics, Inc.

  • Rural Health Clinic/Center
  • Wisconsin Rapids, WI
  • NPI 1568821122
  Care Compare group
• Riverside Physician Services Inc

  • Gastroenterology Physician
  • Williamsburg, VA
  • NPI 1083867311
  NPD
• Riverside Physician Services, Inc.

  • Family Medicine Physician
  • Newport News, VA
  • NPI 1710020623

  Surgery

  NPD
• Aspirus Stevens Point Hospital & Clinics, Inc.

  • Clinic/Center
  • Stevens Point, WI
  • NPI 1679706022
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Aspirus Riverview Hospital & Clinics, Inc.

  • Rural Health Clinic/Center
  • Marshfield, WI
  • NPI 1124633870

  Hospital

  Care Compare affiliation
• Aspirus Riverview Hospital & Clinics, Inc.

  • General Acute Care Hospital
  • Wisconsin Rapids, WI
  • NPI 1295754844

  Hospital

  Care Compare affiliation
• Sanford Health Network

  • General Acute Care Hospital
  • Aberdeen, SD
  • NPI 1235406455

  Hospital

  Care Compare affiliation
• Sanford Health Network

  • General Acute Care Hospital
  • Aberdeen, SD
  • NPI 1639423957

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1334620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1659638575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633D MEDICAL GROUP",
            "address_2": "77 NEALY AVE",
            "city": "JOINT BASE LANGLEY-EUSTIS",
            "state": "VA",
            "postal_code": "236652040",
            "telephone_number": "757-764-6950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3015 3rd Ave SE",
            "address_purpose": "LOCATION",
            "city": "Aberdeen",
            "state": "SD",
            "postal_code": "574015418",
            "country_code": "US",
            "telephone_number": "605-226-5500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Aspirus Doctors Clinics",
            "address_2": "2031 Peach Street",
            "address_purpose": "LOCATION",
            "city": "Wisconsin Rapids",
            "state": "WI",
            "postal_code": "54494",
            "country_code": "US",
            "telephone_number": "715-423-0122",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 Philip Roth St",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236061393",
            "country_code": "US",
            "telephone_number": "757-873-6434",
            "fax_number": "757-873-1882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOURGON",
        "first_name": "ADAM",
        "middle_name": "LABREE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-17",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "02004369A",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0102205429",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "74912",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Burke Allen, PT, DPT
• Jessica Ballard, DNP, WHNP-BC
• Bryan Blazer, D.D.S.
• William E Brooks, MD
• Peter Bradley Broughton, MD
• Andrew Michael Bruton, M.D.
• Adam Buffington, PH.D.
• Angie Cain, IDMT

• All providers in Joint Base Langley-Eustis, VA
• Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2026; 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.