DR. ROOSEVELT BOURSIQUOT M.D., M.PHIL
NPI 1013399872
Internal Medicine in Brooklyn, NY
About Dr. Roosevelt Boursiquot M.d., M.phil NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. ROOSEVELT BOURSIQUOT M.D., M.PHIL (NPI 1013399872) is an individual internal medicine provider in Brooklyn, New York, licensed in New York (287069) and active in the NPI registry since June 2015. He is enrolled in Medicare PECOS, is affiliated with Mount Sinai Hospital, and maintains a secondary practice location in New York.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Roosevelt Boursiquot M.d., M.phil is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
5Medicare enrollment records show Roosevelt Boursiquot reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Brooklyn, NY 11203
- Reassigned Medicare billing, New York enrollment
- 291 clinicians in this Medicare group
New York, NY 10019
- Reassigned Medicare billing, New York enrollment
- 769 clinicians in this Medicare group
New Hyde Park, NY 11040
- Reassigned Medicare billing, New York enrollment
- 9,353 clinicians in this Medicare group
Port Jefferson, NY 11777
- Reassigned Medicare billing, New York enrollment
- Medicare enrollment name: Port Emergency Medical Services PC
- 90 clinicians in this Medicare group
Philadelphia, PA 19152
- Reassigned Medicare billing, New York enrollment
- 11 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 5
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Mount Sinai Hospital
Acute Care Hospitals · New York, NYSt John's Episcopal Hospital At South Shore
Acute Care Hospitals · Far Rockaway, NYPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 11203 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Referred Medical Equipment & Supplies CMS DME claims 2
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
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.
BROOKLYN, NY 11203
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 Roosevelt Boursiquot's NPI number?
The NPI number for Roosevelt Boursiquot is 1013399872. It was assigned to this individual provider in the NPPES registry on June 29, 2015.
Where is Roosevelt Boursiquot located?
Roosevelt Boursiquot practices at 470 Clarkson Ave Msc#59, Brooklyn, NY 11203. The listed phone number is (718) 270-7207.
What is Roosevelt Boursiquot's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Roosevelt Boursiquot enrolled in Medicare?
Yes. Roosevelt Boursiquot is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Roosevelt Boursiquot's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Roosevelt Boursiquot reassigns Medicare benefits to 5 organizations: University Physicians Of Brooklyn, Inc. (Brooklyn, NY), Icahn School Of Medicine At Mount Sinai (New York, NY), North Shore - Lij Medical PC (New Hyde Park, NY), Port Emergency Medical Services, P.C. (Port Jefferson, NY) and Inhospital Physicians Corp (Philadelphia, PA). Each 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 Roosevelt Boursiquot's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Roosevelt Boursiquot affiliated with any hospitals?
According to CMS data, Roosevelt Boursiquot is affiliated with Mount Sinai Hospital and St John's Episcopal Hospital At South Shore.
When was this NPI record last updated?
The NPPES record for Roosevelt Boursiquot was last updated on February 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Dr. Roosevelt Boursiquot, M.D., M.PHIL · NPI 1013399872
Internal Medicine physician in Brooklyn, New York. Individual provider, active in the CMS NPPES registry since June 29, 2015.
## Identity
- **NPI:** 1013399872 (Entity type: Individual)
- **Enumerated:** June 29, 2015
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **State license:** 287069 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 470 CLARKSON AVE, MSC#59, Brooklyn, NY 11203
- **Phone:** (718) 270-7207
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 5 organizations under Medicare reassignment (form CMS-855R): University Physicians Of Brooklyn, Inc. (NPI 1467409912, Brooklyn, NY); Icahn School Of Medicine At Mount Sinai (NPI 1124550280, New York, NY); North Shore - Lij Medical PC (NPI 1790043479, New Hyde Park, NY); Port Emergency Medical Services, P.C. (NPI 1912988395, Port Jefferson, NY); Inhospital Physicians Corp (NPI 1073971750, Philadelphia, PA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2015
## Record status
- **NPPES last updated:** February 10, 2022
- **Other identifiers:** Medicaid 05234079 (NY)
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Source: [NPI Profile](https://npiprofile.com/npi/1013399872) · Data from the CMS NPPES public registry.