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ANDRE BOURG MD
NPI 1871174508
Anesthesiology in Birmingham, AL

Active since April 15, 2021PECOS EnrolledAccepts Medicare Assignment
625 19TH STREET SOUTH, BIRMINGHAM, AL 35249(205) 934-4696 Get Directions Write a Review

NPPES record last updated: June 13, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 13, 2025, Apr 15, 2021 (2 updates tracked since 2021).

About Andre Bourg Md NPPES

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

ANDRE BOURG MD (NPI 1871174508) is an individual anesthesiology provider in Birmingham, Alabama, licensed in South Carolina (94155) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS, is affiliated with Self Regional Healthcare, and maintains a secondary practice location in Greenwood.

NPPES Registry Identity

NPI1871174508
Entity TypeIndividualMale
Primary Taxonomy207L00000X
Provider Legal NameANDRE BOURGCredential: MD
Location Address625 19TH STREET SOUTHBirmingham, AL 35249-1900
Mailing Address625 19th Street SouthBirmingham, AL 35249-1900
Phone(205) 934-4696
Sole ProprietorNo
Medical School CMSMedical University Of South Carolina College Of MedicineGraduated 2021
Enumeration DateApril 15, 2021
Last NPPES UpdateJune 13, 20252 updates tracked since enumeration
NPPES CertifiedJune 13, 2025
✔ NPI 1871174508 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
License✔ Licensed in SC · 94155
Definition
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
625 19TH STREET SOUTH, Birmingham, AL 35249
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Secondary Practice Location 1

Location 11325 Spring StGreenwood, SC 29646-3860 · Phone (864) 725-4111

Other Identifiers 1

Medicaid941556SC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of North Carolina.Insurance ›

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

Andre Bourg Md 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.

PECOS PAC ID749705887
PECOS Enrollment IDI20250422000243
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 Andre Bourg reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Self Medical Group
260 mi
Family Medicine
207 HOLIDAY ROAD
Mccormick, SC 29835
  • Reassigned Medicare billing, South Carolina enrollment
  • 560 clinicians in this Medicare group
NPI 1629382056 (864) 391-5011

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Self Regional Healthcare

Acute Care Hospitals · Greenwood, SC
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number420071
Location1325 Spring StreetGreenwood, SC 29646 · Greenwood County
Emergency services Birthing friendly

Abbeville Area Medical Center

Critical Access Hospitals · Abbeville, SC
OwnershipVoluntary non-profit - Other
CMS Certification Number421301
Location420 Thomson CircleAbbeville, SC 29620 · Abbeville County
Emergency services

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.

STEPHANIE ROSE SAWYER
Dentist (General Practice)
625 19TH STREET SOUTH
BIRMINGHAM, AL 35249
Jefferson County (205) 934-4178
LAIA JIMENA VAZQUEZ GUILLAMET M.D.
Internal Medicine (Infectious Disease)
625 19TH STREET SOUTH
BIRMINGHAM, AL 35249
Jefferson County (205) 934-5191
DR. WILLIAM JARED DALY M.D.
Anesthesiology
625 19TH STREET SOUTH
BIRMINGHAM, AL 35249
Jefferson County (205) 934-4696
MS. CATHERINE DENISHA CHENEY FNP-C
Nurse Practitioner (Family)
625 19TH STREET SOUTH
BIRMINGHAM, AL 35249
Jefferson County (601) 815-3781
DR. CARL JOHNSON JR. M.D./PH.D.
Student in an Organized Health Care Education/Training Program
625 19TH STREET SOUTH
BIRMINGHAM, AL 35249
Jefferson County (205) 934-9600
VICTORIA AMANDA WHEELER
Obstetrics & Gynecology
625 19TH STREET SOUTH
BIRMINGHAM, AL 35249
Jefferson County (205) 934-7872
OLIVER SINQUEFIELD
Hospitalist
625 19TH STREET SOUTH
BIRMINGHAM, AL 35249
Jefferson County (205) 934-2490
DR. ANNE BYRD MAHONEY MD
Student in an Organized Health Care Education/Training Program
625 19TH STREET SOUTH
BIRMINGHAM, AL 35249
Jefferson County (205) 638-9589

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 Andre Bourg's NPI number?

The NPI number for Andre Bourg is 1871174508. It was assigned to this individual provider in the NPPES registry on April 15, 2021.

Where is Andre Bourg located?

Andre Bourg practices at 625 19th Street South, Birmingham, AL 35249. The listed phone number is (205) 934-4696.

What is Andre Bourg's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Is Andre Bourg enrolled in Medicare?

Yes. Andre Bourg 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 organization bills Medicare for Andre Bourg's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Andre Bourg reassigns Medicare benefits to Self Medical Group (Mccormick, SC). 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 Andre Bourg's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Andre Bourg accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care and Ambetter of North Carolina list Andre Bourg as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Andre Bourg affiliated with any hospitals?

According to CMS data, Andre Bourg is affiliated with Self Regional Healthcare and Abbeville Area Medical Center.

When was this NPI record last updated?

The NPPES record for Andre Bourg was last updated on June 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.