KRISTIN BOURG (PA) – Physician Assistant, NPI 1619475530
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in GA
Provider Addresses for KRISTIN BOURG (PA)
264 19th St NW Ste 2240
Atlanta, GA 303631139
Phone: (404) 532-1564
Fax: (404) 532-1565
Type: Location
Butterfield Road, Downers Grove, DuPage County, Illinois, 60128, United States
DOWNERS GROVE, IL 605151069
Phone: (630) 725-2730
Fax: (844) 205-5691
Type: Mailing
Peachtree Road, Brookwood, Atlanta, Fulton County, Georgia, 30363, United States
ATLANTA, GA 30309
Phone: (404) 605-2800
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $59.
Total Amount is formed as General ($59) + Research ($0) + Ownership ($0) = $59.
Last reported payment date: 2024-02-22 • Largest payer in this snapshot: Smith+Nephew, Inc. ($34).
Total Amount
$59
General + Research + Ownership
Payments
2
Total payment records
General Amount
$59
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-02-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Smith+Nephew, Inc. | $34 |
| Medline Industries LP | $25 |
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: 2018-06-01
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180601000390 | I | Physician Assistant | GA | 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 |
|---|---|---|---|---|
| Q4253 | Zenith amniotic membrane, per square centimeter | 2,462 | 12 | $0 |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 1,793 | 269 | $0 |
| 11047 | Removal of bone, each additional 20.0 sq cm or less | 627 | 31 | $0 |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 245 | 124 | $0 |
| 99305 | Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes | 240 | 215 | $0 |
Insurance plans in this area (ZIP 30363)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | GA | |
| Emergency Medicine | GA |
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