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DR. JONATHAN BOURNE M.D.
NPI 1013062660
Anesthesiology in Mammoth Lakes, CA

Active since January 24, 2007PECOS Enrolled
85 SIERRA PARK RD, MAMMOTH LAKES, CA 93546(760) 924-4078(760) 924-4058 Get Directions Write a Review

NPPES record last updated: July 23, 2010. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Jonathan Bourne M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JONATHAN BOURNE M.D. (NPI 1013062660) is an individual anesthesiology provider in Mammoth Lakes, California, licensed in California (G48548) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1013062660
Entity TypeIndividualMale
Primary Taxonomy207L00000X
Provider Legal NameDR. JONATHAN BOURNECredential: M.D.
Location Address85 SIERRA PARK RDMammoth Lakes, CA 93546-0660
Mailing AddressPo Box 660, 85 Sierra Park RdMammoth Lakes, CA 93546-0660 · (760) 924-4078 · Fax (760) 924-4058
Phone(760) 924-4078
Fax(760) 924-4058
Sole ProprietorYes
Enumeration DateJanuary 24, 2007
Last NPPES UpdateJuly 23, 2010
✔ NPI 1013062660 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
License✔ Licensed in CA · G48548
Definition
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
85 SIERRA PARK RD, Mammoth Lakes, CA 93546
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jonathan Bourne M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jonathan Bourne reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern Mono Health Care District
Same address
Critical Access Hospital
85 SIERRA PARK RD
Mammoth Lakes, CA 93546
  • Reassigned Medicare billing, California enrollment
  • 113 clinicians in this Medicare group
NPI 1962444059 (760) 934-3311

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PHYLLIS LEE MENESES RN
Registered Nurse (Registered Nurse First Assistant)
85 SIERRA PARK RD
MAMMOTH LAKES, CA 93546
Mono County (760) 924-4075
DR. PAMELA LANDSTEINER MUNDELL M.D.
Dermatology
85 SIERRA PARK RD
MAMMOTH LAKES, CA 93546
Mono County (760) 934-3311
ERIKO SUZUKI R.N., M.S., N.P.
Nurse Practitioner (Family)
85 SIERRA PARK RD
MAMMOTH LAKES, CA 93546
Mono County (760) 934-2551
JENNIFER WATSON RN
Registered Nurse
85 SIERRA PARK RD
MAMMOTH LAKES, CA 93546
Mono County (760) 934-3311
RENEE ELIZABETH HARTSMAN FNP
Registered Nurse
85 SIERRA PARK RD
MAMMOTH LAKES, CA 93546
Mono County (760) 934-3311
SOUTHERN MONO HEALTH CARE DISTRICT
General Acute Care Hospital (Rural)
85 SIERRA PARK RD
MAMMOTH LAKES, CA 93546
Mono County (760) 934-3311
DR. KIM ESCUDERO M.D.
Pediatrics
85 SIERRA PARK RD
MAMMOTH LAKES, CA 93546
Mono County (760) 924-4000
KYLE ANTHONY MINKEL
Orthopaedic Surgery
85 SIERRA PARK RD
MAMMOTH LAKES, CA 93546
Mono County (760) 934-3311

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jonathan Bourne's NPI number?

The NPI number for Jonathan Bourne is 1013062660. It was assigned to this individual provider in the NPPES registry on January 24, 2007.

Where is Jonathan Bourne located?

Jonathan Bourne practices at 85 Sierra Park Rd, Mammoth Lakes, CA 93546. The listed phone number is (760) 924-4078.

What is Jonathan Bourne's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Is Jonathan Bourne enrolled in Medicare?

Yes. Jonathan Bourne is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jonathan Bourne's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jonathan Bourne reassigns Medicare benefits to Southern Mono Health Care District (Mammoth Lakes, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jonathan Bourne's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jonathan Bourne was last updated on July 23, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.