Adam Labree Bourgon, DO is a medicare enrolled "Surgery" physician in Joint Base Langley-eustis, Virginia. He went to University Of New England, College Of Osteo Medicine and graduated in 2012 and has 12 years of diverse experience with area of expertise as General Surgery. He is a member of the group practice Aspirus Riverview Hospital And Clinics Inc, Aspirus Riverview Hospital And Clinics Inc and his current practice location is
633d Medical Group, 77 Nealy Ave, Joint Base Langley-eustis, Virginia. You can reach out to his office (for appointments etc.) via phone at
(757) 764-6950.
Adam Labree Bourgon is licensed to practice in Indiana (license number 02004369A) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1659638575.
Physician's Profile
| Full Name | Adam Labree Bourgon |
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| Gender | Male |
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| Speciality | General Surgery |
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| Experience | 12 Years |
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| Location | 633d Medical Group, Joint Base Langley-eustis, Virginia |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Adam Labree Bourgon attended and graduated from University Of New England, College Of Osteo Medicine in 2012
NPI Data:
- NPI Number: 1659638575
- Provider Enumeration Date: 04/17/2012
- Last Update Date: 05/03/2021
Medicare PECOS Information:
- PECOS PAC ID: 4688803281
- Enrollment ID: I20201203000888
Medical Identifiers
Medical identifiers for Adam Labree Bourgon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1659638575 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208600000X | Surgery | 74912 (Wisconsin) | Secondary |
| 208600000X | Surgery | 0102205429 (Virginia) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 208600000X | Surgery | 02004369A (Indiana) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Aspirus Riverview Hospital And Clinics Inc | 4587658182 | 142 |
| Aspirus Riverview Hospital And Clinics Inc | 4587658182 | 142 |
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. Adam Labree Bourgon allows following entities to bill medicare on his behalf.
| Entity Name | Riverside Physician Services Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1194929026
PECOS PAC ID: 5092608448
Enrollment ID: O20040207000400 |
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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. Adam Labree Bourgon 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 |
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Adam Labree Bourgon, DO
633d Medical Group, 77 Nealy Ave,
Joint Base Langley-eustis, VA 23665-2040
Ph: (757) 225-4263 | Adam Labree Bourgon, DO
633d Medical Group, 77 Nealy Ave,
Joint Base Langley-eustis, VA 23665-2040
Ph: (757) 764-6950 |
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