MR. RYAN BOURGOINE
NPI 1215744990
Nurse Practitioner - Acute Care in Albuquerque, NM
About Mr. Ryan Bourgoine NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. RYAN BOURGOINE (NPI 1215744990) is an individual acute care provider in Albuquerque, New Mexico, licensed in New Mexico (90733) and active in the NPI registry since December 2024. He is enrolled in Medicare PECOS, maintains a secondary practice location in Plymouth, and is a graduate of Other (2026).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mr. Ryan Bourgoine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Ryan Bourgoine reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Albuquerque, NM 87109
- Reassigned Medicare billing, New Mexico enrollment
- 554 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 87102 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 Ryan Bourgoine's NPI number?
The NPI number for Ryan Bourgoine is 1215744990. It was assigned to this individual provider in the NPPES registry on December 16, 2024.
Where is Ryan Bourgoine located?
Ryan Bourgoine practices at 504 Elm St NE, Albuquerque, NM 87102. The listed phone number is (505) 841-1000.
What is Ryan Bourgoine's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.
Is Ryan Bourgoine enrolled in Medicare?
Yes. Ryan Bourgoine is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Ryan Bourgoine's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ryan Bourgoine reassigns Medicare benefits to Southwest Medical Associates, LLC (Albuquerque, NM). 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 Ryan Bourgoine'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 Ryan Bourgoine was last updated on July 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.
# Mr. Ryan Bourgoine · NPI 1215744990
Acute Care physician in Albuquerque, New Mexico. Individual provider, active in the CMS NPPES registry since December 16, 2024.
## Identity
- **NPI:** 1215744990 (Entity type: Individual)
- **Enumerated:** December 16, 2024
- **Primary specialty:** Nurse Practitioner - Acute Care · taxonomy 363LA2100X
- **State license:** 90733 (New Mexico)
- **Sole proprietor:** No
## Practice location
- **Address:** 504 ELM ST NE, Albuquerque, NM 87102-2512
- **Phone:** (505) 841-1000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Southwest Medical Associates, LLC (NPI 1164491072, Albuquerque, NM), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2026
## Record status
- **NPPES last updated:** July 27, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1215744990) · Data from the CMS NPPES public registry.