| Corey Craig Bousquet, PA-C | |
|
1918 Black Rock Tpke, Fairfield, CT 06825-3543 | |
| (203) 583-8400 | |
| Not Available |
| Full Name | Corey Craig Bousquet |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 24 Years |
| Location | 1918 Black Rock Tpke, Fairfield, Connecticut |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598717571 | NPI | - | NPPES |
| 291035 | Other | FL | AMERIGROUP |
| 292171500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA9102466 (Florida) | Secondary |
| 363A00000X | Physician Assistant | 2478 (Connecticut) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Afc Physicians Of Connecticut Pc | 5193966893 | 39 |
| Quentin Medical Group Llc | 4981833647 | 13 |
| Qmg2, Llc | 0345541512 | 13 |
| Qmg3 Llc | 8628353117 | 18 |
| Qmg4 Llc | 4284912957 | 15 |
| Qmg7 Llc | 0749642726 | 15 |
| Qmg5,llc | 2062820913 | 17 |
| Entity Name | Nes Medical Services of Northern Connecticut, P.C. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447231865 PECOS PAC ID: 7315843968 Enrollment ID: O20040112000084 |
| Entity Name | Northeast Emergency Medicine Specialists LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982889598 PECOS PAC ID: 8729157797 Enrollment ID: O20080516000028 |
| Entity Name | Afc Physicians of Connecticut PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003152984 PECOS PAC ID: 5193966893 Enrollment ID: O20130723000274 |
| Entity Name | Quentin Medical Group LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487087250 PECOS PAC ID: 4981833647 Enrollment ID: O20140130000098 |
| Entity Name | Qmg2, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437546363 PECOS PAC ID: 0345541512 Enrollment ID: O20151211000754 |
| Entity Name | Qmg4 LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023471299 PECOS PAC ID: 4284912957 Enrollment ID: O20161031002469 |
| Entity Name | Qmg3 LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053856039 PECOS PAC ID: 8628353117 Enrollment ID: O20170324000321 |
| Entity Name | Hartford Healthcare Urgent Care Centers LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093239683 PECOS PAC ID: 7618242777 Enrollment ID: O20170929001464 |
| Entity Name | Nems PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114482882 PECOS PAC ID: 2466792833 Enrollment ID: O20190321000650 |
| Entity Name | Qmg5,llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386233344 PECOS PAC ID: 2062820913 Enrollment ID: O20210414002118 |
| Entity Name | Qmg7 LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487367199 PECOS PAC ID: 0749642726 Enrollment ID: O20230809000584 |
| Mailing Address | Practice Location Address |
|---|---|
| Corey Craig Bousquet, PA-C 45 Maler Ave, Shelton, CT 06484-5925 Ph: (305) 528-9800 | Corey Craig Bousquet, PA-C 1918 Black Rock Tpke, Fairfield, CT 06825-3543 Ph: (203) 583-8400 |
Nikita Shadani, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5151 Park Ave, Fairfield, CT 06825 Phone: 203-371-7999 |
Samantha Kennedy, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 5151 Park Ave, Masters Of Physician Assistant Studies Program, Fairfield, CT 06825 Phone: 203-989-9237 |
Mr. Daniel George Stewart, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 425 Post Rd, Fairfield, CT 06824 Phone: 203-292-9000 |
Skylar Krystina Robinson, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 425 Post Rd, Fairfield, CT 06824 Phone: 203-259-7442 |
Miss Emily Knowlton, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 2000 Post Rd Ste 202, Fairfield, CT 06824 Phone: 203-254-9454 Fax: 203-254-0152 |
Fiore F Soviero, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 305 Black Rock Tpke, Orthopaedic Specialty Group, Fairfield, CT 06825 Phone: 203-337-2600 Fax: 203-337-2666 |
Brian Clancy, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 425 Post Rd, Fairfield, CT 06824 Phone: 203-292-9000 |