ADRIANA M BOURNE (PA) – Physician Assistant, NPI 1194288720
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
6,066 PHYSICIAN ASSISTANT in MI
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Provider Addresses for ADRIANA M BOURNE (PA)
4480 HAGADORN RD APT 204
OKEMOS, MI 488642471
Phone: (509) 942-9161
Type: Mailing
505, North Clippert Street, Frandor Shopping Center, Lansing, Ingham County, Michigan, 48912, United States
LANSING, MI 489124701
Phone: (517) 999-2273
Type: Location
505 N Clippert St
Lansing, MI 489124701
Phone: (517) 999-2273
Type: Location
1 HURLEY PLZ
FLINT, MI 485035902
Phone: (810) 262-9000
Type: Mailing
24 FRANK LLOYD WRIGHT DRIVE
SUITE J2000
ANN ARBOR, MI 48105
Phone: (734) 747-6766
Fax: (734) 222-3100
Type: Mailing
14555 LEVAN RD
STE 311
LIVONIA, MI 48154
Phone: (734) 655-2692
Fax: (734) 655-4218
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 $1,824.
Total Amount is formed as General ($1,824) + Research ($0) + Ownership ($0) = $1,824.
Last reported payment date: 2024-12-23 • Largest payer in this snapshot: Teleflex LLC ($868).
Total Amount
$1,824
General + Research + Ownership
Payments
63
Total payment records
General Amount
$1,824
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Teleflex LLC | $868 |
| COLOPLAST CORP | $215 |
| UROGEN PHARMA, INC. | $113 |
| Dendreon Pharmaceuticals LLC | $81 |
| ABBVIE INC. | $68 |
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: 2019-06-14
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 |
|---|---|---|---|---|
| I20190614001551 | I | Physician Assistant | MI | 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 48864)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| Physician Assistant | MI | |
| Physician Assistant | MI | |
| - | MI | |
| Physician Assistant | MI | |
| Physician Assistant | CA | |
| Physician Assistant | MI | |
| Nurse Practitioner | MI | |
| - | MI | |
| Physician Assistant | OH |
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