Jean-Robert Boursiquot, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

156767 Issued in NY

Practice address

97-03 Springfield Blvd.
Queens Village, NY 11429

Phone

(718) 465-7200

Fax

(718) 465-0407

NPI assigned

Oct 17, 2006

Sex

Male

Sole proprietor

Yes

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

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

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.

• SLB Medical Associates

  • Pediatrics Physician
  • Corona, NY
  • NPI 1750519690
  NPD (past) Authorized official

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333411200000",
    "number": "1902987134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 TALON WAY",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117466238",
            "telephone_number": "631-242-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97-03 SPRINGFIELD BLVD.",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "11429",
            "telephone_number": "718-465-7200",
            "fax_number": "718-465-0407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURSIQUOT",
        "first_name": "JEAN-ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2012-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "156767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shavon Boston
• Margo Brenda Bou8Cher, LPN
• Delourdes Bouchereau, LPN
• Gertha Boucicault
• Jean Marc R Boucicault
• Sarah Bowe
• Shanice Bowen-Murray
• Annalisa Boyd, LPN
• Braddock Express Inc
• Brandon Ramnarain Physical Therapy PLLC

• Pediatrics Physician in Queens Village, NY
• Providers in Queens Village, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; 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.