SOUFYANE BOURASS – Psychiatric/Mental Health Nurse Practitioner, NPI 1306590633

SOUFYANE BOURASS is a healthcare provider. based in Saint johns, Florida. specializing in NURSE PRACTITIONER. They hold a License No. APRN11017959 (FL). The NPI Number for SOUFYANE BOURASS is 1306590633

Main info

Male
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
SOUFYANE BOURASS
NPI
1306590633
Phone
(812) 870-8683
Address
88 LOCHNAGAR MOUNTAIN DR
Enumeration Date
6 February 2022
Last Update Date
3 August 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9047472157
Graduation Year
2021 (5 years ago)
PAC ID
2860853017
Group Practice PAC ID
5193197002
Professional Enrollment ID
I20230803002731
Address ID
FL320920000SA135XXSTXX500

Contacts

Secure Messaging
sbourass@epicbh.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness85
Years active:4State licenses:1Other namesUpdated within 12 months

24,243 NURSE PRACTITIONER in FL

Provider Addresses for SOUFYANE BOURASS

  • 88 LOCHNAGAR MOUNTAIN DR

    SAINT JOHNS, FL 322596672

    Phone: (812) 870-8683

    Type: Mailing

  • 1400 OLD DIXIE HWY

    SAINT AUGUSTINE, FL 320844190

    Phone: (904) 824-0724

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 63 Open Payments records for all available years, with a total value of $1,385.

Total Amount is formed as General ($1,385) + Research ($0) + Ownership ($0) = $1,385.

Last reported payment date: 2024-12-11 • Largest payer in this snapshot: ABBVIE INC. ($549).

Total Amount

$1,385

General + Research + Ownership

Payments

63

Total payment records

General Amount

$1,385

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-11

Latest reported date

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: 2023-08-03

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
I20230803002731INurse PractitionerFLTBD

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 32259)

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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: 5193197002View full group profile
NameSpecialtyState
Nurse PractitionerFL

Reviews

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Frequently asked questions

What unique ID ties claims to SOUFYANE BOURASS?
NPI 1306590633 is assigned to SOUFYANE BOURASS under the national enumeration system.
Is SOUFYANE BOURASS active in the national directory?
SOUFYANE BOURASS's public NPI profile is in an active state.
Does SOUFYANE BOURASS list a primary specialty?
If you are matching referrals, note Psychiatric/Mental Health Nurse Practitioner for SOUFYANE BOURASS. Clinical services aligned with this taxonomy classification.
What location shows for SOUFYANE BOURASS?
We surface Saint Johns, Florida for SOUFYANE BOURASS based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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