Melissa Nicole Bourque, APRN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

059980-23 Issued in NH

Practice address

984 Whittier Hwy
Moultonborough Family Medicine
Moultonborough, NH 03254

Phone

(603) 476-2216

Fax

(603) 476-5396

NPI assigned

Jul 26, 2016

Last updated

May 18, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Melissa Nicole La Branche Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NH

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

Merit-based Incentive Payment System (MIPS)

Final score

65.17 of 100Reported as group

Quality

47.69

Improvement activities

40

Cost

79.8

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: melissabourque@gohnh.allscriptsdirect.net
• Direct secure messaging: melissabourque@huggins.medalliesdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Huggins Hospital

  • Critical Access Hospital
  • Wolfeboro, NH
  • NPI 1366476079
  Medicare reassignment NPD
• Catholic Medical Center

  • Cardiovascular Disease Physician
  • Manchester, NH
  • NPI 1386672319
  NPD
• Huggins Hospital

  dba Huggins Hospital Cancer Care & Infusion Center

  • Hematology & Oncology Physician
  • Wolfeboro, NH
  • NPI 1942018353
  NPD
• Huggins Hospital

  dba Moultonborough Family Medicine

  • Family Medicine Physician
  • Moultonborough, NH
  • NPI 1639166077
  NPD (past)

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1962955062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 SOUTH MAIN ST.",
            "city": "WOLFEBORO",
            "state": "NH",
            "postal_code": "03894",
            "telephone_number": "603-569-7500",
            "fax_number": "603-515-2031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "984 WHITTIER HWY",
            "address_2": "MOULTONBOROUGH FAMILY MEDICINE",
            "city": "MOULTONBOROUGH",
            "state": "NH",
            "postal_code": "03254",
            "telephone_number": "603-476-2216",
            "fax_number": "603-476-5396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURQUE",
        "first_name": "MELISSA",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-26",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NH",
            "license": "059980-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "moultonboroughfamilymed@gohnh.allscriptsdirect.net",
            "affiliation": "Y",
            "endpointDescription": "direct messaging",
            "affiliationName": "Huggins Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "984 Whittier Hwy",
            "address_2": "Moultonborough Family Medicine",
            "city": "Moultonborough",
            "state": "NH",
            "country_code": "US",
            "postal_code": "03254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "LA BRANCHE",
            "middle_name": "NICOLE",
            "prefix": "MS.",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Allstar Medical Supply Corporation
• And Then There Is You PLLC
• Sarah Bauer, LMFT
• Bearpac Medical LLC
• Celine Bolduc
• Brain Waves PLLC
• Jennifer Jean Burke, LMHC
• Kenneth Caldwell
• April Womack Chambers, DVM
• Justin Clark, PT, DPT

• Adult Health Nurse Practitioner in Moultonborough, NH
• Providers in Moultonborough, NH by specialty
• Adult Health Nurse Practitioner in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.