1. Home
  2. Directory
  3. Louisiana
  4. New Orleans
  5. Pediatrics
  6. NPI Profile

MICA GOULBOURNE MD
NPI 1093276966
Pediatrics - Child Abuse Pediatrics in New Orleans, LA

Active since March 25, 2019PECOS Enrolled
1140 CALHOUN ST, NEW ORLEANS, LA 70118(504) 896-9827 Get Directions Write a Review

NPPES record last updated: August 7, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mica Goulbourne Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICA GOULBOURNE MD (NPI 1093276966) is an individual child abuse pediatrics provider in New Orleans, Louisiana, licensed in Louisiana (346102) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS and is a graduate of Medical College Of Georgia School Of Medicine (2019).

NPPES Registry Identity

NPI1093276966
Entity TypeIndividualFemale
Primary Taxonomy2080C0008X
Provider Legal NameMICA GOULBOURNECredential: MD
Location Address1140 CALHOUN STNew Orleans, LA 70118-5962
Mailing Address1100 Poydras StNew Orleans, LA 70163-1101 · (504) 527-9952 · Fax (504) 527-9950
Phone(504) 896-9827
Sole ProprietorNo
Medical School CMSMedical College Of Georgia School Of MedicineGraduated 2019
Enumeration DateMarch 25, 2019
Last NPPES UpdateAugust 7, 2025
NPPES CertifiedAugust 7, 2025
✔ NPI 1093276966 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Child Abuse PediatricsAllopathic & Osteopathic Physicians
Taxonomy Code2080C0008X
License✔ Licensed in LA · 346102
Definition
A Child Abuse Pediatrician serves as a resource to children, families and communities by accurately diagnosing abuse; consulting with community agencies on child safety; providing expertise in courts of law; treating consequences of abuse and neglect; directing child abuse and neglect prevention programs and participating on multidisciplinary teams investigating; and managing child abuse cases.
1140 CALHOUN ST, New Orleans, LA 70118
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mica Goulbourne Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3971838293
PECOS Enrollment IDI20250820004102
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mica Goulbourne's NPI number?

The NPI number for Mica Goulbourne is 1093276966. It was assigned to this individual provider in the NPPES registry on March 25, 2019.

Where is Mica Goulbourne located?

Mica Goulbourne practices at 1140 Calhoun St, New Orleans, LA 70118. The listed phone number is (504) 896-9827.

What is Mica Goulbourne's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Child Abuse Pediatrics, with taxonomy code 2080C0008X.

Is Mica Goulbourne enrolled in Medicare?

Yes. Mica Goulbourne is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mica Goulbourne was last updated on August 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.