DOUGLAS RENE BOURGON (M.D.) – Diagnostic Radiology Physician, NPI 1730138876
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,800 DIAGNOSTIC RADIOLOGY in CA
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Provider Addresses for DOUGLAS RENE BOURGON (M.D.)
FILE 1687
1801 W OLYMPIC BLVD
PASADENA, CA 911991687
Phone: (415) 750-5687
Fax: (415) 683-5591
Type: Mailing
Saint Mary's Medical Center, 450, Stanyan Street, Haight-Ashbury, San Francisco, California, 94117, United States
SAN FRANCISCO, CA 941171019
Phone: (415) 750-5687
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2010-11-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040814000226 | I | Diagnostic Radiology | CA | TBD |
| I20101112000144 | I | Diagnostic Radiology | FL | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 71045 | X-ray of chest, 1 view | 612 | 568 | $0 |
| 70450 | Ct scan head or brain without contrast | 270 | 267 | $0 |
| 74177 | Ct scan of abdomen and pelvis with contrast | 222 | 218 | $0 |
| 71275 | Ct scan of blood vessels of chest with contrast | 128 | 128 | $0 |
| 74176 | Ct scan of abdomen and pelvis without contrast | 113 | 112 | $0 |
Insurance plans in this area (ZIP 91199)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DIAGNOSTIC RADIOLOGY | CA | 71250 | CT scan chest | 49 | 47 |
| DIAGNOSTIC RADIOLOGY | CA | 73110 | X-ray of wrist, minimum of 3 views | 28 | 27 |
| DIAGNOSTIC RADIOLOGY | CA | 74177 | CT scan of abdomen and pelvis with contrast | 151 | 145 |
| DIAGNOSTIC RADIOLOGY | CA | 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 31 | 31 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | NY | |
| Diagnostic Radiology | NJ | |
| Diagnostic Radiology | CO | |
| Diagnostic Radiology | CA | |
| Diagnostic Radiology, Interventional Radiology | CA | |
| Diagnostic Radiology | LA | |
| Diagnostic Radiology | WA | |
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | CA |
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