Coty Bourque, is a medicare enrolled "Social Worker - Clinical" provider in Glenwood Springs, Colorado. His current practice location is
1905 Blake Ave Ste 101, Glenwood Springs, Colorado. You can reach out to his office (for appointments etc.) via phone at
(970) 945-2840.
Coty Bourque is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1356850960.
Healthcare Provider's Profile
Full Name | Coty Bourque |
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Gender | Male |
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Speciality | Social Worker - Clinical |
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Location | 1905 Blake Ave Ste 101, Glenwood Springs, Colorado |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1356850960
- Provider Enumeration Date: 09/26/2017
- Last Update Date: 11/14/2022
Medicare PECOS Information:
- PECOS PAC ID: 1557739745
- Enrollment ID: I20221118001570
Medical Identifiers
Medical identifiers for Coty Bourque such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1356850960 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Coty Bourque allows following entities to bill medicare on his behalf.
Entity Name | Grand River Hospital District |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1124074042 PECOS PAC ID: 7113837469 Enrollment ID: O20040310000898 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Coty Bourque is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Coty Bourque, 209 W Main St Ste 200, New Iberia, LA 70560-3862 Ph: () - | Coty Bourque, 1905 Blake Ave Ste 101, Glenwood Springs, CO 81601-4206 Ph: (970) 945-2840 |
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