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ALEXANDRA BOURSIQUOT
NPI 1245752278
Nurse Practitioner - Psychiatric/Mental Health in Hyattsville, MD

Active since July 11, 2017PECOS Enrolled
4206 75TH AVE, HYATTSVILLE, MD 20784(240) 413-1255(301) 576-8573 Get Directions Write a Review

NPPES record last updated: November 25, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 25, 2025, May 10, 2024, Jul 21, 2022 and 1 more (4 updates tracked since 2017).

About Alexandra Boursiquot NPPES

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

ALEXANDRA BOURSIQUOT (NPI 1245752278) is an individual psychiatric/mental health provider in Hyattsville, Maryland, licensed in Maryland (R226935) and active in the NPI registry since July 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1245752278
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameALEXANDRA BOURSIQUOT
Location Address4206 75TH AVEHyattsville, MD 20784-2318
Mailing Address4206 75th AveHyattsville, MD 20784-2318 · (240) 413-1255 · Fax (301) 576-8573
Phone(240) 413-1255
Fax(301) 576-8573
Sole ProprietorYes
Enumeration DateJuly 11, 2017
Last NPPES UpdateNovember 25, 20254 updates tracked since enumeration
NPPES CertifiedNovember 25, 2025
✔ NPI 1245752278 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in MD · R226935
Also ListedRegistered NurseTaxonomy 163W00000X · License RN1044797 (DC)
4206 75TH AVE, Hyattsville, MD 20784
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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)

Alexandra Boursiquot 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 Reassignments

2

Medicare enrollment records show Alexandra Boursiquot reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Bridge Integrating Group Practice LLC
33 mi
Psychiatric/Mental Health
6600 YORK RD STE 103
Baltimore, MD 21212
  • Reassigned Medicare billing, Maryland enrollment
  • 6 clinicians in this Medicare group
NPI 1821711706 (443) 384-5255
Positive Pathways And Wellness Center
66 mi
Psychiatric/Mental Health
28 JONATHAN ST
Hagerstown, MD 21740
  • Reassigned Medicare billing, District of Columbia enrollment
  • 3 clinicians in this Medicare group
NPI 1679313761 (240) 413-1255

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 20784 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$100.31 typical visit price
range $65.18 – $194.86
Typical copayment $25.07 (range $16.29 – $48.71)
Most-billed visit code 99203
Established Patient
$113.72 typical visit price
range $21.40 – $158.88
Typical copayment $28.43 (range $5.35 – $39.72)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Alexandra Boursiquot's NPI number?

The NPI number for Alexandra Boursiquot is 1245752278. It was assigned to this individual provider in the NPPES registry on July 11, 2017.

Where is Alexandra Boursiquot located?

Alexandra Boursiquot practices at 4206 75th Ave, Hyattsville, MD 20784. The listed phone number is (240) 413-1255.

What is Alexandra Boursiquot's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Alexandra Boursiquot enrolled in Medicare?

Yes. Alexandra Boursiquot is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Alexandra Boursiquot's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Alexandra Boursiquot reassigns Medicare benefits to 2 organizations: Bridge Integrating Group Practice LLC (Baltimore, MD) and Positive Pathways And Wellness Center (Hagerstown, MD). 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 Alexandra Boursiquot'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 Alexandra Boursiquot was last updated on November 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.