Michael R Bouska, M.D., M.P.H

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

R73221 Issued in AZ

Practice address

1253 NW Canal Blvd
Redmond, OR 97756-1334

Phone

(541) 548-8131

Fax

(541) 526-6608

NPI assigned

Jul 19, 2012

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mbouska18253@secure.stcharleshealthcare.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.

• St. Charles Health System, Inc.

  • Family Medicine Physician
  • Bend, OR
  • NPI 1023331303
  Medicare reassignment NPD
• St. Charles Health System, Inc.

  • Critical Access Hospital
  • Madras, OR
  • NPI 1356389894

  Emergency Medicine

  Medicare reassignment NPD
• St. Charles Health System, Inc.

  • Critical Access Hospital
  • Prineville, OR
  • NPI 1710160445

  Emergency Medicine

  Medicare reassignment NPD
• St. Charles Health System, Inc.

  • General Acute Care Hospital
  • Bend, OR
  • NPI 1982621447

  Emergency Medicine

  Medicare reassignment NPD
• St. Charles Health System, Inc.

  • Specialist
  • Bend, OR
  • NPI 1700697935
  NPD

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587081600000",
    "number": "1669727145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2322 N NORRIS AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857193826",
            "telephone_number": "319-493-1361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1253 NW CANAL BLVD",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561334",
            "telephone_number": "541-548-8131",
            "fax_number": "541-526-6608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUSKA",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.,  M.P.H",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-19",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "R73221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbouska18253@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "1253 NW Canal Blvd",
            "city": "Redmond",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977561334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrea Boothby, CADC
• Olivia Boots, CRNA
• Don R. Borjesson, LCSW
• Lindsey Bosse
• Michelle Elizabeth Boulanger, QMHP
• Shasta Bowen
• Arandalin F Bowman, LMT
• Jessica Marie Brace
• Mary Alice Bradshaw
• Angela Brady

• Emergency Medicine Physician in Redmond, OR
• Providers in Redmond, OR by specialty
• Emergency Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.