Brandon Kyle Bourgoin, DPT is a medicare enrolled "Physical Medicine & Rehabilitation" physician in Kennebunk, Maine. He graduated from medical school in 2020 and has 5 years of diverse experience with area of expertise as Physical Therapist In Private Practice. He is a member of the group practice Bay State Physical Therapy Of Randolph Inc and his current practice location is
65 Portland Rd Ste 5, Kennebunk, Maine. You can reach out to his office (for appointments etc.) via phone at
(207) 985-6181.
Brandon Kyle Bourgoin is licensed to practice in Maine (license number PT5831) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1215532668.
Physician's Profile
| Full Name | Brandon Kyle Bourgoin |
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| Gender | Male |
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| Speciality | Physical Therapist In Private Practice |
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| Experience | 5 Years |
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| Location | 65 Portland Rd Ste 5, Kennebunk, Maine |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Brandon Kyle Bourgoin graduated from medical school in 2020
NPI Data:
- NPI Number: 1215532668
- Provider Enumeration Date: 12/03/2020
- Last Update Date: 12/03/2020
Medicare PECOS Information:
- PECOS PAC ID: 8123431533
- Enrollment ID: I20250116002365
Medical Identifiers
Medical identifiers for Brandon Kyle Bourgoin such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1215532668 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208100000X | Physical Medicine & Rehabilitation | PT5831 (Maine) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Bay State Physical Therapy Of Randolph Inc | 6305744251 | 365 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Brandon Kyle Bourgoin allows following entities to bill medicare on his behalf.
| Entity Name | Bay State Physical Therapy Of Randolph Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1164474334
PECOS PAC ID: 6305744251
Enrollment ID: O20191112001187 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Brandon Kyle Bourgoin is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Brandon Kyle Bourgoin, DPT
17 Irving St Apt 201,
Saco, ME 04072-3226
Ph: (207) 631-1166 | Brandon Kyle Bourgoin, DPT
65 Portland Rd Ste 5,
Kennebunk, ME 04043-6742
Ph: (207) 985-6181 |
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