DR. LARRY AVIS BOURG (M.D.) – Specialist, NPI 1205800182

DR. LARRY AVIS BOURG (M.D.) is a healthcare provider. based in Greenwood village, Colorado. specializing in Specialist. They hold the professional credentials M.D.. They hold a License No. 39560 (CO). The NPI Number for DR. LARRY AVIS BOURG (M.D.) is 1205800182

Main info

Male
Name
DR. LARRY AVIS BOURG (M.D.)
NPI
1205800182
Phone
(720) 644-9355
Address
9250 E COSTILLA AVE STE 540
Enumeration Date
15 February 2006
Last Update Date
8 August 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

Provider Addresses for DR. LARRY AVIS BOURG (M.D.)

  • 9250 E COSTILLA AVE STE 540

    GREENWOOD VILLAGE, CO 801123648

    Phone: (720) 644-9355

    Type: Mailing

  • 12230 LIONESS WAY

    PARKER, CO 801345603

    Phone: (720) 644-9355

    Type: Location

  • Denver Veterans Affairs Medical Center, 1055, Clermont Street, Denver, Denver County, Colorado, 80220, United States

    DENVER, CO 80220

    Phone: (303) 399-8020

    Fax: (303) 393-5128

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2008-12-03

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
I20081203000336IInternal MedicineCOTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99306Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes102101$0
99309Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes2222$0
99310Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes1313$0
View full utilization report →

Insurance plans in this area (ZIP 80112)

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Reviews

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Frequently asked questions

Is DR. LARRY AVIS BOURG (M.D.) listed with a National Provider Identifier?
Yes — DR. LARRY AVIS BOURG (M.D.) has NPI 1205800182 on file in the registry.
Would DR. LARRY AVIS BOURG (M.D.) appear as active to a payer?
You can treat DR. LARRY AVIS BOURG (M.D.) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with DR. LARRY AVIS BOURG (M.D.)?
DR. LARRY AVIS BOURG (M.D.)'s record emphasizes Other Service Providers. Clinical services aligned with this taxonomy classification.
Is DR. LARRY AVIS BOURG (M.D.) associated with Greenwood Village?
Public fields place DR. LARRY AVIS BOURG (M.D.) around Greenwood Village, Colorado. Always confirm the exact site before visiting.
Can I trust this NPI listing for DR. LARRY AVIS BOURG (M.D.)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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