| Dr Michael Ray Bourne, MD | |
|
1500 Curve Crest Blvd W, Stillwater, MN 55082-6040 | |
| (651) 439-1234 | |
| (651) 275-3325 |
| Full Name | Dr Michael Ray Bourne |
|---|---|
| Gender | Male |
| Speciality | Podiatry |
| Experience | 38 Years |
| Location | 1500 Curve Crest Blvd W, Stillwater, Minnesota |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164412649 | NPI | - | NPPES |
| 164225100 | Medicaid | MN | |
| 43222300 | Medicaid | WI |
| Facility Name | Location | Facility Type |
|---|---|---|
| Westfields Hospital And Clinic | New richmond, WI | Hospital |
| Amery Hospital & Clinic | Amery, WI | Hospital |
| Lakeview Memorial Hospital | Stillwater, MN | Hospital |
| Hudson Hospital | Hudson, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Tria Orthopaedic Center Llc | 3173570561 | 461 |
| Amery Regional Medical Center Inc | 2769391960 | 100 |
| Tria Orthopaedic Center Llc | 3173570561 | 461 |
| Provider Name | Group Health Plan Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1710924683 PECOS PAC ID: 1759293954 Enrollment ID: O20031105000417 |
| Provider Name | Tria Orthopaedic Center Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1518273085 PECOS PAC ID: 3173570561 Enrollment ID: O20110310000999 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Michael Ray Bourne, MD 8170 33rd Ave S # Ms 21110q, Minneapolis, MN 55425-4516 Ph: () - | Dr Michael Ray Bourne, MD 1500 Curve Crest Blvd W, Stillwater, MN 55082-6040 Ph: (651) 439-1234 |
Dr. Christina Marie Knutson, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1500 Curve Crest Blvd W, Stillwater, MN 55082 Phone: 651-439-1234 Fax: 651-439-1547 | |
Maplewood Podiatry, Llc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 1940 Greeley St S, Suite 122, Stillwater, MN 55082 Phone: 651-439-5278 |