1. Home
  2. Directory
  3. New York
  4. Brooklyn
  5. Physician Assistant
  6. NPI Profile

MISS RENEE JEAN BOURGAULT PA-C
NPI 1033952593
Physician Assistant - Medical in Brooklyn, NY

Active since June 13, 2024PECOS Enrolled
374 STOCKHOLM ST, BROOKLYN, NY 11237(718) 963-7272 Get Directions Write a Review

NPPES record last updated: June 13, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Miss Renee Jean Bourgault Pa-c NPPES

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

MISS RENEE JEAN BOURGAULT PA-C (NPI 1033952593) is an individual medical provider in Brooklyn, New York and active in the NPI registry since June 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1033952593
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMISS RENEE JEAN BOURGAULTCredential: PA-C
Location Address374 STOCKHOLM STBrooklyn, NY 11237-4006
Mailing Address374 Stockholm StBrooklyn, NY 11237-4006 · (718) 963-7272
Phone(718) 963-7272
Sole ProprietorYes
Enumeration DateJune 13, 2024
NPPES CertifiedMay 30, 2024
✔ NPI 1033952593 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
374 STOCKHOLM ST, Brooklyn, NY 11237
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Miss Renee Jean Bourgault Pa-c 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.

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.

GABY DABOUL M.D
General Acute Care Hospital
374 STOCKHOLM ST
BROOKLYN, NY 11237
Kings County (718) 963-7272
AMIT DHALIWAL MD
Internal Medicine (Infectious Disease)
374 STOCKHOLM ST
BROOKLYN, NY 11237
Kings County (718) 963-7272
SAMER ATTIA MD
Internal Medicine
374 STOCKHOLM ST
BROOKLYN, NY 11237
Kings County (718) 963-6466
TECIA MADURIE RN
Registered Nurse
374 STOCKHOLM ST
BROOKLYN, NY 11237
Kings County (718) 501-1983
DR. FARIDEH ZONOUZI-ZADEH M.D.
Family Medicine
374 STOCKHOLM ST, C/O FACULTY PRACTICE
BROOKLYN, NY 11237
Kings County (718) 963-6551
DR. BALA KRISHNA BABJI RAVI M.D.
Obstetrics & Gynecology
374 STOCKHOLM ST, C/O FACULTY PRACTICE
BROOKLYN, NY 11237
Kings County (718) 963-6551
DIANE CHRIST P.A.
Physician Assistant
374 STOCKHOLM ST, C/O FACULTY PRACTICE MANAGEMENT SUITE I-37 NORTH
BROOKLYN, NY 11237
Kings County (718) 963-6551
MRS. BHAKTI SHAH RPA-C
Physician Assistant
374 STOCKHOLM ST, C/O FACULTY PRACTICE MANAGEMENT-SUITE I37N
BROOKLYN, NY 11237
Kings County (914) 654-6543

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 Renee Bourgault's NPI number?

The NPI number for Renee Bourgault is 1033952593. It was assigned to this individual provider in the NPPES registry on June 13, 2024.

Where is Renee Bourgault located?

Renee Bourgault practices at 374 Stockholm St, Brooklyn, NY 11237. The listed phone number is (718) 963-7272.

What is Renee Bourgault's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Renee Bourgault enrolled in Medicare?

Yes. Renee Bourgault is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Renee Bourgault was last updated on June 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.