Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Justin Bourque, PA-C

Individual provider Surgical Physician Assistant · NPI 1649089087

Justin Bourque, PA-C is a Physician Assistant in Stamford, Connecticut. Qualified in 2024, 2 years ago. Practices with Stamford Health Medical Group Inc, a 432-clinician group and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
2
Licensed in
CT
In the registry since
2024
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1 Hospital Plz
Stamford, CT 06902-3602
Phone: (203) 279-7022
Fax: (203) 276-5560
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 6945 (CT)

Record details

NPI number1649089087
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 31, 2024
Last updated in NPPESMarch 7, 2025
Certification dateMarch 7, 2025
Mailing address1 Hospital Plz, Stamford, CT 06902-3602

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Stamford Health Medical Group Inc — 432 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Stamford