CHERYL R BOURGAULT (PA C) – Physician Assistant, NPI 1205823036
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,876 PHYSICIAN ASSISTANT in OR
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Provider Addresses for CHERYL R BOURGAULT (PA C)
PO BOX 10605
360 S GARDEN WAY, SUITE 210
EUGENE, OR 974402605
Phone: (541) 683-3202
Fax: (541) 868-1063
Type: Mailing
360, South Garden Way, Eugene, Lane County, Oregon, 97401, United States
SUITE 210
EUGENE, OR 974018173
Phone: (541) 683-3202
Fax: (541) 868-1063
Type: Location
360 S GARDEN WAY STE 210
EUGENE, OR 974018186
Phone: (541) 683-3202
Fax: (541) 868-1063
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 95 Open Payments records for all available years, with a total value of $1,665.
Total Amount is formed as General ($1,665) + Research ($0) + Ownership ($0) = $1,665.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: ABBVIE INC. ($506).
Total Amount
$1,665
General + Research + Ownership
Payments
95
Total payment records
General Amount
$1,665
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
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $506 |
| Janssen Biotech, Inc. | $389 |
| E.R. Squibb & Sons, L.L.C. | $331 |
| UCB, Inc. | $134 |
| LEO Pharma Inc. | $62 |
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: 2010-12-30
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 |
|---|---|---|---|---|
| I20101230000618 | I | Physician Assistant | OR | 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 |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 510 | 116 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 253 | 212 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 206 | 163 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 111 | 96 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 90 | 90 | $0 |
Insurance plans in this area (ZIP 97440)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | OR |
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