Sean David Bourne, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101263331 Issued in VA

Practice address

7190 Crestwood Blvd
Frederick, MD 21703-7314

Phone

(240) 529-1700

NPI assigned

Jun 22, 2016

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC, MD2 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 2

Specialty

Family Practice

Education

State University of New York at Buffalo School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, 1,921 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Halethorpe, MD
  • NPI 1043378656
  Medicare reassignment Care Compare group NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Annapolis, MD
  • NPI 1952461816

  DC, Family Medicine

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • MC Lean, VA
  • NPI 1376815472
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1700237534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 E JEFFERSON ST",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524908",
            "telephone_number": "800-777-7904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7190 CRESTWOOD BLVD",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217037314",
            "telephone_number": "240-529-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURNE",
        "first_name": "SEAN",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-22",
        "last_updated": "2021-07-26",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116029690",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101263331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2101 E Jefferson St",
            "city": "Rockville",
            "state": "MD",
            "country_code": "US",
            "postal_code": "208524908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Erin Boss
• Alyssa Michelle Bosso, MD
• Boston Brace International Inc.
• Jean Louise Bourg, P.T.
• David Steven Bourgeois, PHARM.D.
• Jessica Boursiquot
• Vanessa L Bowens, ADT
• Kristi G Bowerman
• Margaret Sky Bowes
• Teresa L Bowie, MPT

• Family Medicine Physician in Frederick, MD
• Providers in Frederick, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.