Kimberly Brooke Rivera Bourke, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA057178 Issued in PA

Practice address

530 E Cedar St
Elizabethtown, PA 17022-2516

Phone

(717) 588-1059

Fax

(717) 689-1246

NPI assigned

Feb 8, 2014

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 DC, PA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbourke206410@direct-lghealth.org

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.

• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480

  DC

  Medicare reassignment NPD
• Lancaster General Medical Group

  • Psychiatry Physician
  • Lancaster, PA
  • NPI 1952392383

  PA

  Medicare reassignment
• Lancaster General Medical Group

  • Obstetrics & Gynecology Physician
  • Lancaster, PA
  • NPI 1306724570
  NPD
• Lancaster General Medical Group

  • Family Medicine Physician
  • Gap, PA
  • NPI 1922037126
  NPD
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD
• Lancaster General Medical Group

  • Family Medicine Physician
  • Strasburg, PA
  • NPI 1316912785
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1391817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1992129142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 E CEDAR ST",
            "city": "ELIZABETHTOWN",
            "state": "PA",
            "postal_code": "170222516",
            "telephone_number": "717-588-1059",
            "fax_number": "717-689-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 E CEDAR ST",
            "city": "ELIZABETHTOWN",
            "state": "PA",
            "postal_code": "170222516",
            "telephone_number": "717-588-1059",
            "fax_number": "717-689-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURKE",
        "first_name": "KIMBERLY",
        "middle_name": "BROOKE RIVERA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-08",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA057178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hillary Shearer Bossert-Davis, LCSW
• Bouquet Mulligan Demaio Eye Professionals
• Bouquet Mulligan Demaio Eye Professionals
• Bouquet Mulligan Eye Professionals LTD
• Bouquet Mulligan Eye Professionals LTD
• Christopher David Brabazon, DO
• Breakthrough Music Therapy LLC
• Zachary Bricker, CRNP
• Stephanie Bridgehouse
• Anikka Brill

• All providers in Elizabethtown, PA
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; 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.