DR. BRENDA BOURASSA (DO) – Nephrology Physician, NPI 1184726978

DR. BRENDA BOURASSA (DO) is a healthcare provider. based in Fort lauderdale, Florida. specializing in Nephrology Physician. They hold the professional credentials DO. They hold a License No. OS7548 (FL). The NPI Number for DR. BRENDA BOURASSA (DO) is 1184726978

Main info

Female
34 Years Of Experience
Accepts Medicare Assignment
Name
DR. BRENDA BOURASSA (DO)
NPI
1184726978
Phone
(954) 463-0112
Address
407 SE 9TH ST
Enumeration Date
2 September 2006
Last Update Date
16 February 2016

Doctor Profile

Medical School Name
UNIVERSITY OF NEW ENGLAND, COLLEGE OF OSTEO MEDICINE
Secondary Phone
9544630112
Graduation Year
1992 (34 years ago)
PAC ID
2365488806
Group Practice PAC ID
6103884820
Professional Enrollment ID
I20050706000462
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

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Provider Addresses for DR. BRENDA BOURASSA (DO)

  • 407, Southeast 9th Street, Fort Lauderdale, Broward County, Florida, 33316, United States

    SUITE 103

    FORT LAUDERDALE, FL 333161113

    Phone: (954) 463-0112

    Fax: (954) 463-0117

    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)

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: 2005-07-06

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
I20050706000462INephrologyFLTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33316)

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Reviews

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Frequently asked questions

What number should I use to identify DR. BRENDA BOURASSA (DO) for billing?
Administrative and clinical systems typically use NPI 1184726978 for DR. BRENDA BOURASSA (DO).
Does the public listing show DR. BRENDA BOURASSA (DO) as active?
DR. BRENDA BOURASSA (DO)'s NPI record reflects an active status in NPPES.
What services align with DR. BRENDA BOURASSA (DO)'s listing?
DR. BRENDA BOURASSA (DO)'s public classification highlights Nephrology Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to DR. BRENDA BOURASSA (DO)?
DR. BRENDA BOURASSA (DO) is associated with Fort Lauderdale, Florida in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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