Dustin Debourge, MSN, AGNP-BC in Columbia, MO

Dustin Debourge, MSN, AGNP-BC is a medicare enrolled "Nurse Practitioner - Gerontology" in Columbia, Missouri. His current practice location is 6 Lucerne Ct, Columbia, Missouri. You can reach out to his office (for appointments etc.) via phone at (537) 303-8025.

Dustin Debourge is licensed to practice in Missouri (license number 2020038126) 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 1720688914.

Contact Information

	Dustin Debourge, MSN, AGNP-BC
	6 Lucerne Ct, Columbia, MO 65203-2931
	(537) 303-8025
	Not Available

Map and Direction

Provider's Profile

Full Name	Dustin Debourge
Gender	Male
Speciality	Nurse Practitioner - Gerontology
Location	6 Lucerne Ct, Columbia, Missouri
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1720688914
Provider Enumeration Date: 10/28/2020
Last Update Date: 11/01/2024

Medicare PECOS Information:

PECOS PAC ID: 5496167538
Enrollment ID: I20210106003150

Medical Identifiers

Medical identifiers for Dustin Debourge such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1720688914	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LG0600X	Nurse Practitioner - Gerontology	2020038126 (Missouri)	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. Dustin Debourge allows following entities to bill medicare on his behalf.

Entity Name	Spectrum Health Care
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1063785442 PECOS PAC ID: 9830457811 Enrollment ID: O20171220002604

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. Dustin Debourge 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
Dustin Debourge, MSN, AGNP-BC 785 Elkridge Landing Rd Ste 300, Linthicum Heights, MD 21090-2958 Ph: (443) 275-9800	Dustin Debourge, MSN, AGNP-BC 6 Lucerne Ct, Columbia, MO 65203-2931 Ph: (537) 303-8025

Reviews and Comments

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Dustin Debourge, MSN, AGNP-BC - Medicare Nurse Practitioner in Columbia, MO