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MARY PAIGE BOURBEAU ARNP
NPI 1255672796
Nurse Practitioner - Family in St Petersburg, FL

Active since March 07, 2013PECOS Enrolled
5500 9TH ST N., ST PETERSBURG, FL 33703(727) 322-1054(727) 821-7213 Get Directions Write a Review

NPPES record last updated: November 22, 2017. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Mary Paige Bourbeau Arnp NPPES

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

MARY PAIGE BOURBEAU ARNP (NPI 1255672796) is an individual family provider in St Petersburg, Florida, licensed in Florida (9253468) and active in the NPI registry since March 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1255672796
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMARY PAIGE BOURBEAUCredential: ARNP
Location Address5500 9TH ST N.St Petersburg, FL 33703
Mailing Address1839 Central AveSt Petersburg, FL 33713-8900 · (727) 322-1054 · Fax (727) 821-7213
Phone(727) 322-1054
Fax(727) 821-7213
Sole ProprietorYes
Enumeration DateMarch 7, 2013
Last NPPES UpdateNovember 22, 2017
✔ NPI 1255672796 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in FL · 9253468✔ Licensed in FL · ARNP 9253468
5500 9TH ST N., St Petersburg, FL 33703
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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)

Mary Paige Bourbeau Arnp 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 Mary Bourbeau reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Professional Health Care Of Pinellas LLC
3.6 mi
Internal Medicine
1839 CENTRAL AVE
St Petersburg, FL 33713
  • Reassigned Medicare billing, Florida enrollment
  • 220 clinicians in this Medicare group
NPI 1881647253 (727) 322-1054

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 33703 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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 Mary Bourbeau's NPI number?

The NPI number for Mary Bourbeau is 1255672796. It was assigned to this individual provider in the NPPES registry on March 7, 2013.

Where is Mary Bourbeau located?

Mary Bourbeau practices at 5500 9th St N., St Petersburg, FL 33703. The listed phone number is (727) 322-1054.

What is Mary Bourbeau's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Mary Bourbeau enrolled in Medicare?

Yes. Mary Bourbeau is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mary Bourbeau's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Bourbeau reassigns Medicare benefits to Professional Health Care Of Pinellas LLC (St Petersburg, FL). 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 Mary Bourbeau'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 Mary Bourbeau was last updated on November 22, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.