Mathieu Bourassa, HEARING AID DISPENSE

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

HADE12739 Issued in AZ

Practice address

1721 N Dysart Rd
Avondale, AZ 85392-1222

Phone

(623) 663-3100

NPI assigned

Dec 5, 2022

Last updated

Dec 5, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1902516586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16814 S 15TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850450763",
            "telephone_number": "401-207-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 N DYSART RD",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853921222",
            "telephone_number": "623-663-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURASSA",
        "first_name": "MATHIEU",
        "credential": "HEARING AID DISPENSE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-05",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "AZ",
            "license": "HADE12739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan Boss
• Monique Bostick
• Esmeralda Botello
• Jocelyn Constance Bouchard, NMD
• Joyce Akosua Bour, FNP-C
• Brandon Bowman
• Kyla Boyd, D.M.D.
• Brandon Bracy, COTA/L
• Braddy Mental Health and Addiction Services
• Alexia Bradshaw

• Hearing Instrument Specialist in Avondale, AZ
• Providers in Avondale, AZ by specialty
• Hearing Instrument Specialist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.