Individual provider Active NPI

Irama Debourg

  • Occupational Therapist
  • Miramar, FL
National Provider Identifier
1952548877
Registry record updated Jan 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT8571 Issued in FL
Practice address
3051 SW 135TH Ave
Miramar, FL 33027-3920
Phone
(954) 885-9339
NPI assigned
Jan 14, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT8571 FL Primary

Addresses

Primary practice location

3051 SW 135TH Ave
Miramar, FL 33027-3920

Mailing address

3051 SW 135TH Ave
Miramar, FL 33027-3920
Phone (954) 885-9339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050606000548 FL Practitioner - Occupational Therapist in Private Practice 8921041575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bolanos Associates, LLC.Group PAC ID 0840327342, 16 clinicians

Practice addresses (Care Compare)

1150 NW 72ND Ave
Suite 720
Miami, FL 33126-1932
Phone (866) 693-0181

7340 NW 5TH St
Plantation, FL 33317-1605
Phone (786) 259-0300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231891200000",
    "number": "1952548877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3051 SW 135TH AVE",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330273920",
            "telephone_number": "954-885-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3051 SW 135TH AVE",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330273920",
            "telephone_number": "954-885-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBOURG",
        "first_name": "IRAMA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-14",
        "last_updated": "2009-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT8571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.