Ann Van Bourg, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

6655 Alvarado Rd
San Diego, CA 92120-5208

Phone

(619) 287-3270

NPI assigned

Nov 12, 2020

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.67 of 100Reported as group

Quality

81.04

Promoting interoperability

99

Improvement activities

40

Cost

82.04

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ann.lovell.1@9170.direct.athenahealth.com
• Direct secure messaging: avanbourg32532@sharphealthcare.direct-ci.com

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.

• Sharp Rees-Stealy Medical Group, Inc

  • Internal Medicine Physician
  • San Diego, CA
  • NPI 1285616177

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Emergency Physicians Urgent Care Inc.

  • Urgent Care Clinic/Center
  • Bakersfield, CA
  • NPI 1689963845
  Medicare reassignment NPD
• Alvarado Emergency Medical Associates, Inc.

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1285811992
  Medicare reassignment
• Doctors on Duty Medical Group, Inc

  • Urgent Care Clinic/Center
  • Salinas, CA
  • NPI 1568465466
  Medicare reassignment
• Temecula Valley Emergency Physicians, Inc

  • Emergency Medicine Physician
  • Temecula, CA
  • NPI 1407281223
  Medicare reassignment
• Sharp Rees-Stealy Medical Group, Inc

  • Optometrist
  • San Diego, CA
  • NPI 1063172351
  NPD
• Sharp Rees-Stealy Medical Center

  • Physical Therapist
  • Chula Vista, CA
  • NPI 1407096589
  NPD (past)

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

{
    "created_epoch": "1605139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1992307078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13727 CONDESA DR",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920143301",
            "telephone_number": "760-331-7425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6655 ALVARADO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205208",
            "telephone_number": "619-287-3270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1756 N Main St",
            "address_purpose": "LOCATION",
            "city": "Salinas",
            "state": "CA",
            "postal_code": "939065103",
            "country_code": "US",
            "telephone_number": "831-443-8200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13727 Condesa Dr",
            "address_purpose": "LOCATION",
            "city": "Del Mar",
            "state": "CA",
            "postal_code": "920143301",
            "country_code": "US",
            "telephone_number": "760-331-7425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN BOURG",
        "first_name": "ANN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-12",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992307078",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sergio Dominique Vamper
• Vamsi K Aribindi MD Medical Corporation
• Mariana Van Antwerp
• Michael Gabriel Van Bebber
• Kai Rond Van Bodegom-Smith, L.AC.
• Koenraad Van Braeckel, PHD
• Jonathan Van de Leuv, MD
• Yaroll Van de Vin
• Erik Francis Van Den Akker
• Ellis Petronella Van Den Boogaard, MS ED., MA

• Physician Assistant in San Diego, CA
• Providers in San Diego, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; 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.