DR. MICHAEL PAUL BOURGOIN (O.D.) – Optometrist, NPI 1720197361

DR. MICHAEL PAUL BOURGOIN (O.D.) is a healthcare provider. based in Costa mesa, California. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 9870T (CA). The NPI Number for DR. MICHAEL PAUL BOURGOIN (O.D.) is 1720197361

Main info

Male
34 Years Of Experience
Accepts Medicare Assignment
Name
DR. MICHAEL PAUL BOURGOIN (O.D.)
NPI
1720197361
Phone
(949) 646-4949
Address
1835 NEWPORT BLVD
Enumeration Date
29 August 2006
Last Update Date
2 November 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9496464949
Graduation Year
1992 (34 years ago)
PAC ID
1557371739
Group Practice PAC ID
8820008006
Professional Enrollment ID
I20060503000323
Address ID
CA926275014CO1835XBLVD301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

3,909 OPTOMETRY in CA

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Provider Addresses for DR. MICHAEL PAUL BOURGOIN (O.D.)

  • Yard House, 1835, Newport Boulevard, Costa Mesa, Orange County, California, 92627, United States

    SUITE A-111

    COSTA MESA, CA 926275031

    Phone: (949) 646-4949

    Fax: (949) 646-2533

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $69.

Total Amount is formed as General ($69) + Research ($0) + Ownership ($0) = $69.

Last reported payment date: 2024-05-22 • Largest payer in this snapshot: Johnson & Johnson Vision Care, Inc. ($40).

Total Amount

$69

General + Research + Ownership

Payments

3

Total payment records

General Amount

$69

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-22

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2006-05-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060503000323IOptometryCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92014Established patient complete exam of visual system3333$0
99213Established patient office or other outpatient visit, 20-29 minutes3223$0
92004New patient complete exam of visual system2424$0
92250Photography of the retina1818$0
99205New patient office or other outpatient visit, 60-74 minutes1212$0
View full utilization report →

Insurance plans in this area (ZIP 92627)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8820008006View full group profile
NameSpecialtyState
O P T O M E T R YCA

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. MICHAEL PAUL BOURGOIN (O.D.)?
DR. MICHAEL PAUL BOURGOIN (O.D.) — NPI 1720197361 — is the standard way to identify this listing.
Is DR. MICHAEL PAUL BOURGOIN (O.D.) still practicing?
DR. MICHAEL PAUL BOURGOIN (O.D.) is currently listed as active in the public NPI registry.
What taxonomy line describes DR. MICHAEL PAUL BOURGOIN (O.D.)?
For research purposes, treat DR. MICHAEL PAUL BOURGOIN (O.D.) as Optometrist in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect DR. MICHAEL PAUL BOURGOIN (O.D.) on a map?
Expect Costa Mesa, California as a primary anchor for DR. MICHAEL PAUL BOURGOIN (O.D.) unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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