CAROLINE SAMANTHA BOURASSA CPNP
NPI 1760968408
Nurse Practitioner - Pediatrics in New York, NY

Q: What is Caroline Bourassa's NPI number?

The NPI number for Caroline Bourassa is 1760968408. It was assigned to this individual provider in the NPPES registry on July 16, 2018.

Q: What is Caroline Bourassa's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Q: When was this NPI record last updated?

The NPPES record for Caroline Bourassa was last updated on March 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since July 16, 2018PECOS EnrolledAccepts Medicare Assignment

1275 YORK AVE, NEW YORK, NY 10065(212) 639-2000 Get Directions Write a Review

NPPES record last updated: March 16, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 7, 2022, Jul 16, 2018 (2 updates tracked since 2018).

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About Caroline Samantha Bourassa Cpnp NPPES

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

CAROLINE SAMANTHA BOURASSA CPNP (NPI 1760968408) is an individual pediatrics provider in New York, New York, licensed in New York (382879) and active in the NPI registry since July 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1760968408

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameCAROLINE SAMANTHA BOURASSACredential: CPNP

Location Address1275 YORK AVENew York, NY 10065-6007

Mailing Address1275 York AveNew York, NY 10065-6007

Phone(212) 639-2000

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateJuly 16, 2018

Last NPPES UpdateMarch 16, 20222 updates tracked since enumeration

NPPES CertifiedMarch 16, 2022

✔ NPI 1760968408 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0200X

License✔ Licensed in NY · 382879

1275 YORK AVE, New York, NY 10065

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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

Caroline Samantha Bourassa Cpnp 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 ID143617324

PECOS Enrollment IDI20220419001285

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10065 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

$102.04 typical visit price

range $65.69 – $198.19

Typical copayment $25.51 (range $16.42 – $49.54)

Most-billed visit code 99203

Established Patient

$114.88 typical visit price

range $21.20 – $160.66

Typical copayment $28.72 (range $5.30 – $40.16)

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.

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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.

MRS. ZANA CORREA NP

Nurse Practitioner (Adult Health)