Victoria Bourque, A.P.R.N.

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

001374 Issued in CT

Practice address

55 Nye Rd
Suite 102
Glastonbury, CT 06033-1281

Phone

(860) 657-3056

Fax

(860) 633-3517

NPI assigned

Jul 10, 2006

Last updated

Mar 10, 2014By 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

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Certified Clinical Nurse Specialist (CNS)

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Connecticut Mental Health Specialists IncGroup PAC ID 0345130563, 65 clinicians

Value Based Long Term Care K PCGroup PAC ID 1355881418, 61 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Connecticut Mental Health Specialists Inc

  • Psychiatry Physician
  • Farmington, CT
  • NPI 1053362814

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Value Based Long Term Care K PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Shelton, CT
  • NPI 1831921378
  Medicare reassignment Care Compare group
• The Center for Geriatric and Family Psychiatry, Inc.

  • Mental Health Counselor
  • Glastonbury, CT
  • NPI 1831134766
  Medicare reassignment NPD

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394409600000",
    "number": "1982638375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 NYE RD",
            "address_2": "SUITE 102",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331281",
            "telephone_number": "860-657-3056",
            "fax_number": "860-633-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 NYE RD",
            "address_2": "SUITE 102",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331281",
            "telephone_number": "860-657-3056",
            "fax_number": "860-633-3517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURQUE",
        "first_name": "VICTORIA",
        "credential": "A.P.R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2014-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "001374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Mary Bombassei, LPC-A
• Dinamarie Bonetti, PTA
• Merlyn Bonilla, LMT
• Kerri Booth
• Laura Borodic, DMD
• Patricia Bouwer, RN,MS,FNP
• Glenda D Boyden
• Brady Counseling LLC
• Elizabeth May Brady, M.A., LPC
• William M Brahm, DDS

• Psychiatric/Mental Health Nurse Practitioner in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2014; 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.