ELLIOTTE SCHAFER BOURNE PA-C
NPI 1366155442
Physician Assistant in Rolla, MO

Q: What is Elliotte Bourne's NPI number?

The NPI number for Elliotte Bourne is 1366155442. It was assigned to this individual provider in the NPPES registry on January 3, 2023.

Q: What is Elliotte Bourne's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Elliotte Bourne was last updated on May 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since January 03, 2023PECOS EnrolledAccepts Medicare Assignment

1050 W 10TH ST, ROLLA, MO 65401(573) 364-9000(573) 426-2108 Get Directions Write a Review

NPPES record last updated: May 21, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 21, 2026, Jan 3, 2023 (2 updates tracked since 2023).

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About Elliotte Schafer Bourne Pa-c NPPES

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

ELLIOTTE SCHAFER BOURNE PA-C (NPI 1366155442) is an individual physician assistant in Rolla, Missouri, licensed in Missouri (2024005757) and active in the NPI registry since January 2023. She is enrolled in Medicare PECOS, is affiliated with Phelps County Regional Medical Center, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1366155442

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameELLIOTTE SCHAFER BOURNECredential: PA-C

Location Address1050 W 10TH STRolla, MO 65401-2905

Mailing Address1050 W 10th StRolla, MO 65401-2905 · (573) 364-9000 · Fax (573) 426-2108

Phone(573) 364-9000

Fax(573) 426-2108

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateJanuary 3, 2023

Last NPPES UpdateMay 21, 20262 updates tracked since enumeration

NPPES CertifiedMay 21, 2026

✔ NPI 1366155442 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in MO · 2024005757

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1050 W 10TH ST, Rolla, MO 65401

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Elliotte Schafer Bourne Pa-c 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.

PECOS PAC ID6204271315

PECOS Enrollment IDI20240228003686

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Phelps County Regional Medical Center

Acute Care Hospitals · Rolla, MO

3/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number260017

Location1000 W 10th StRolla, MO 65401 · Phelps County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65401 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

$81.64 typical visit price

range $52.28 – $161.24

Typical copayment $20.41 (range $13.07 – $40.31)

Most-billed visit code 99203

Established Patient

$65.71 typical visit price

range $16.30 – $131.05

Typical copayment $16.42 (range $4.07 – $32.76)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

YAM SHARMA

Pediatrics