Neil Bourjaily, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0004453 Issued in CO

Practice address

2700 NW Stewart Pkwy
Roseburg, OR 97471-1281

Phone

(541) 673-0611

NPI assigned

Mar 11, 2016

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

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• High Plains Community Health Center, Incorporated

  • Federally Qualified Health Center (FQHC)
  • Lamar, CO
  • NPI 1700889151
  Medicare reassignment
• High Plains Community Health Center Incorporated

  • Federally Qualified Health Center (FQHC)
  • Holly, CO
  • NPI 1932596350
  NPD

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

{
    "created_epoch": "1457654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457654400000",
    "number": "1942661426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 NW STEWART PKWY",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711281",
            "telephone_number": "541-673-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 NW STEWART PKWY",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711281",
            "telephone_number": "541-673-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURJAILY",
        "first_name": "NEIL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-11",
        "last_updated": "2016-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0004453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roger Stuart Bothwell, M.D.
• Robert Botkin, AA
• Andrea K. Botwinick, MSED, CCC-SLP
• Shantell Boulware
• Howard Robert Bourdages, M.D.
• Cherise Bowers, RNFA
• Inger C Boyd, MA ED., BS
• Brad E Robinson MD PC
• Braden Partners LP
• Melody Colleen Braden

• Physician Assistant in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; 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.