MRS. LISA ANN BOURQUIN (FNP-APNP) – Family Nurse Practitioner, NPI 1700308558
Family Nurse Practitioner
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
11,637 NURSE PRACTITIONER in IL
Provider Addresses for MRS. LISA ANN BOURQUIN (FNP-APNP)
1 MEDICAL CENTER DR
GALENA, IL 610368118
Phone: (815) 777-1340
Type: Location
Memorial Hospital of Lafayette County, 800, Clay Street, Darlington, Lafayette County, Wisconsin, 53530, United States
DARLINGTON, WI 535301228
Phone: (608) 776-3614
Fax: (608) 776-2317
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 14 Open Payments records for all available years, with a total value of $357.
Total Amount is formed as General ($357) + Research ($0) + Ownership ($0) = $357.
Last reported payment date: 2024-02-21 • Largest payer in this snapshot: Medical Device Business Services, Inc. ($137).
Total Amount
$357
General + Research + Ownership
Payments
14
Total payment records
General Amount
$357
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-02-21
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2024-05-06
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240506000790 | I | Nurse Practitioner | IL | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 61036)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | WI | |
| Family Practice | IL | |
| - | IA | |
| Diagnostic Radiology | IA | |
| Emergency Medicine | IL | |
| Emergency Medicine | MI | |
| Certified Registered Nurse Anesthetist (Crna) | IL | |
| U R O L O G Y | IL | |
| Diagnostic Radiology | TX | |
| - | IA |
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