DR. MICHAEL RAY BOURNE MD NPI 1164412649

NPI Information

  • NPI: 1164412649
  • Provider Name: DR. MICHAEL RAY BOURNE, MD
  • Classification: Podiatrist - 213ES0103X
  • Specialization: Foot & Ankle Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1500 CURVE CREST BLVD W
    STILLWATER, MN
    ZIP 55082
  • Phone: (651) 439-1234

Map and Directions

Get Directions

NPI Details

DR. Michael Ray Bourne, MD is a foot and ankle surgery podiatrist in Stillwater, MN with 38 years of experience. DR. Michael Ray Bourne, MD NPI is 1164412649. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: CALIFORNIA SCHOOL OF PODIATRIC MEDICINE
Graduation Year:1988

The provider's business location address is:

1500 CURVE CREST BLVD W
STILLWATER, MN
ZIP 55082-040
Phone: (651) 439-1234
Fax: (651) 275-3325

The NPI 1164412649 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)
  • Injection into tendon or ligament (HCPCS:20550)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Aspiration and/or injection of fluid from small joint (HCPCS:20600)
  • Lower limb (leg) arthroscopy (minimally invasive joint repair) (HCPCS:NAN15)
  • Melanoma (skin cancer) excision (HCPCS:NAN03)

The enumeration date for this NPI number is 10/25/2005 and was last updated on 6/12/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213E00000XPodiatrist746WISCONSINNo
2213E00000XPodiatrist445MINNESOTANo
3213ES0103XPodiatristFoot & Ankle Surgery746WISCONSINNo
4213ES0103XPodiatristFoot & Ankle Surgery445MINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1164225100MEDICAIDMINNESOTA
243222300MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI