SAMANTHA GOUTERMOUT FNP
NPI 1114657228
Nurse Practitioner - Family in Hannibal, NY
About Samantha Goutermout Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAMANTHA GOUTERMOUT FNP (NPI 1114657228) is an individual family provider in Hannibal, New York, licensed in New York (349656) and active in the NPI registry since June 2022. She is enrolled in Medicare PECOS, is affiliated with Oswego Hospital, and maintains 10 additional practice locations.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 10
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Samantha Goutermout Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Samantha Goutermout reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Oswego, NY 13126
- Reassigned Medicare billing, New York enrollment
- 70 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 2
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Oswego Hospital
Acute Care Hospitals · Oswego, NYPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 13074 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Samantha Goutermout's NPI number?
The NPI number for Samantha Goutermout is 1114657228. It was assigned to this individual provider in the NPPES registry on June 13, 2022.
Where is Samantha Goutermout located?
Samantha Goutermout practices at 953 Auburn St, Hannibal, NY 13074. The listed phone number is (315) 602-4030.
What is Samantha Goutermout's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Samantha Goutermout enrolled in Medicare?
Yes. Samantha Goutermout is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Samantha Goutermout's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Samantha Goutermout reassigns Medicare benefits to Physician Care PC (Oswego, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samantha Goutermout's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Samantha Goutermout affiliated with any hospitals?
According to CMS data, Samantha Goutermout is affiliated with Oswego Hospital.
When was this NPI record last updated?
The NPPES record for Samantha Goutermout was last updated on October 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 days 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.
# Samantha Goutermout, FNP · NPI 1114657228
Family physician in Hannibal, New York. Individual provider, active in the CMS NPPES registry since June 13, 2022.
## Identity
- **NPI:** 1114657228 (Entity type: Individual)
- **Enumerated:** June 13, 2022
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 349656 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 953 AUBURN ST, Hannibal, NY 13074-2180
- **Phone:** (315) 602-4030 · **Fax:** (315) 282-2300
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Physician Care PC (NPI 1073868113, Oswego, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** State University Of Ny Upstate Medical University, class of 2022
## Record status
- **NPPES last updated:** October 15, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1114657228) · Data from the CMS NPPES public registry.