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CHARLES BOURNE
NPI 1326639642
Nurse Practitioner - Gerontology in Philadelphia, PA

Active since January 29, 2021PECOS Enrolled
5528 MORRIS ST, PHILADELPHIA, PA 19144(267) 243-9206 Get Directions Write a Review

NPPES record last updated: January 29, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Charles Bourne NPPES

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

CHARLES BOURNE (NPI 1326639642) is an individual gerontology provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (SP021873) and active in the NPI registry since January 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1326639642
Entity TypeIndividualMale
Primary Taxonomy363LG0600X
Provider Legal NameCHARLES BOURNE
Location Address5528 MORRIS STPhiladelphia, PA 19144-3807
Mailing Address5528 Morris StPhiladelphia, PA 19144-3807 · (267) 243-9206
Phone(267) 243-9206
Sole ProprietorYes
Enumeration DateJanuary 29, 2021
NPPES CertifiedJanuary 29, 2021
✔ NPI 1326639642 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License✔ Licensed in PA · SP021873
5528 MORRIS ST, Philadelphia, PA 19144
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Charles Bourne is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Charles Bourne reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Matrix Medical Plus
685 mi
Nurse Practitioner
424 CHURCH ST STE 2600
Nashville, TN 37219
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 77 clinicians in this Medicare group
NPI 1376973461 (877) 564-3627

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19144 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$92.69 typical visit price
range $59.88 – $180.99
Typical copayment $23.17 (range $14.97 – $45.24)
Most-billed visit code 99203
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Charles Bourne's NPI number?

The NPI number for Charles Bourne is 1326639642. It was assigned to this individual provider in the NPPES registry on January 29, 2021.

Where is Charles Bourne located?

Charles Bourne practices at 5528 Morris St, Philadelphia, PA 19144. The listed phone number is (267) 243-9206.

What is Charles Bourne's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Is Charles Bourne enrolled in Medicare?

Yes. Charles Bourne is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Charles Bourne's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Charles Bourne reassigns Medicare benefits to Matrix Medical Plus (Nashville, TN). 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 Charles Bourne's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Charles Bourne was last updated on January 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.