Michael Hal Bourne Jr., MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

12857513-1205 Issued in UT

Practice address

1160 E 3900 S Ste 4050
Salt Lake City, UT 84124-1264

Phone

(801) 266-3418

NPI assigned

May 22, 2013

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

Medicare fee-for-service enrollment

Enrolled in OR, UT, ID3 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

Pulmonary DiseaseAlso: Critical Care (Intensivists)

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mountainstar Cardiology St Marks LLCGroup PAC ID 2961661855, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mark'S Hospital Hospital, Salt Lake City, UT, CCN 460047
• Lone Peak Hospital Hospital, Draper, UT, CCN 460060
• Holy Cross Hospital-Jordan Valley Hospital, West Jordan, UT, CCN 460051

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mbourne1045282@oc.providencedirect.org
• Direct secure messaging: michael.bourne@hca3.eclinicaldirectplus.com

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.

• Mountainstar Cardiology St Marks LLC

  • Interventional Cardiology Physician
  • Salt Lake City, UT
  • NPI 1437446168
  Medicare reassignment Care Compare group NPD
• Intensive Care Consortium Inc

  • Specialist
  • Aventura, FL
  • NPI 1629019062

  Critical Care Medicine, ID

  Medicare reassignment NPD

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

• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • West Jordan, UT
  • NPI 1801591391
  Care Compare affiliation
• Lone Peak Hospital, Inc.

  • General Acute Care Hospital
  • Draper, UT
  • NPI 1770821571
  Care Compare affiliation
• Northern Utah Healthcare Corporation

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1164469243
  Care Compare affiliation

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

{
    "created_epoch": "1369180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1881030443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741729",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303741729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 E 3900 S STE 4050",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241264",
            "telephone_number": "801-266-3418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURNE",
        "first_name": "MICHAEL",
        "middle_name": "HAL",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-22",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "UT",
            "license": "12857513-1205",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "UT",
            "license": "12857513-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyndall Bounous
• Bountiful Surgery Center, LLC
• Seth Powell Bourgeous
• Bourget Health Services, Inc
• Michael H Bourne, MD
• Robert B Bourne, MD
• John Bovard
• Nicole R Bovard
• Mike Elias Bovos, M.D.
• Anne W Bowden, FNP

• Pulmonary Disease Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Pulmonary Disease Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.