Kia Shalyn Bourdot, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Morristown, New Jersey. Her current practice location is
100 Madison Ave, Morristown, New Jersey. You can reach out to her office (for appointments etc.) via phone at
(973) 971-5000.
Kia Shalyn Bourdot is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1619555216.
Physician's Profile
Full Name | Kia Shalyn Bourdot |
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Gender | Female |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 100 Madison Ave, Morristown, New Jersey |
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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: 1619555216
- Provider Enumeration Date: 04/01/2021
- Last Update Date: 06/19/2024
Medicare PECOS Information:
- PECOS PAC ID: 8426451915
- Enrollment ID: I20210721001694
Medical Identifiers
Medical identifiers for Kia Shalyn Bourdot such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1619555216 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | BOUR-9LQE07 (North Carolina) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
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. Kia Shalyn Bourdot 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 |
Kia Shalyn Bourdot, MD 100 Madison Ave, Morristown, NJ 07960-6136 Ph: (973) 971-5000 | Kia Shalyn Bourdot, MD 100 Madison Ave, Morristown, NJ 07960-6136 Ph: (973) 971-5000 |
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