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TIFFANY WISDOM-GOULBOURNE
NPI 1942041553
Nurse Practitioner - Acute Care in Lancaster, PA

Active since June 06, 2024PECOS EnrolledAccepts Medicare Assignment
217 HARRISBURG AVE, LANCASTER, PA 17603(717) 544-8300 Get Directions Write a Review

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

Record update history: May 7, 2025, Jun 6, 2024 (2 updates tracked since 2024).

About Tiffany Wisdom-goulbourne NPPES

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

TIFFANY WISDOM-GOULBOURNE (NPI 1942041553) is an individual acute care provider in Lancaster, Pennsylvania, licensed in Pennsylvania (SP029670) and active in the NPI registry since June 2024. She is enrolled in Medicare PECOS, is affiliated with Lancaster General Hospital, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1942041553
Entity TypeIndividualFemale
Primary Taxonomy363LA2100X
Provider Legal NameTIFFANY WISDOM-GOULBOURNE
Location Address217 HARRISBURG AVELancaster, PA 17603-2964
Mailing Address30 Edison RdDouglassville, PA 19518-2449
Phone(717) 544-8300
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateJune 6, 2024
Last NPPES UpdateMay 7, 20252 updates tracked since enumeration
NPPES CertifiedMay 7, 2025
✔ NPI 1942041553 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in PA · SP029670
217 HARRISBURG AVE, Lancaster, PA 17603
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.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

Tiffany Wisdom-goulbourne 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 ID5698200111
PECOS Enrollment IDI20241121000095
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.

Lancaster General Hospital

Acute Care Hospitals · Lancaster, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390100
Location555 North Duke StreetLancaster, PA 17602 · Lancaster County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 17603 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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.

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.

MS. KIMBERLY A ANDERSEN CRNP
Nurse Practitioner (Acute Care)
217 HARRISBURG AVE, SUITE 200
LANCASTER, PA 17603
Lancaster County (717) 544-4495
DR. MELISSA LYNN MCKERNAN PULLIAM M.D.
Internal Medicine (Clinical Cardiac Electrophysiology)
217 HARRISBURG AVE, THE HEART GROUP OF LGHEALTH
LANCASTER, PA 17603
Lancaster County (717) 544-8300
DR. DANA M WEINSTEIN D.O.
Internal Medicine (Cardiovascular Disease)
217 HARRISBURG AVE, THE HEART GROUP OF LGHEALTH
LANCASTER, PA 17603
Lancaster County (717) 544-8300
JESSICA NICOLE NORTON CRNP
Nurse Practitioner (Family)
217 HARRISBURG AVE
LANCASTER, PA 17603
Lancaster County (717) 544-8300
STEPHEN IMMANUEL WARREN MD
Internal Medicine (Cardiovascular Disease)
217 HARRISBURG AVE
LANCASTER, PA 17603
Lancaster County (717) 544-8300
ELENA BIGLER CRNP
Nurse Practitioner (Gerontology)
217 HARRISBURG AVE
LANCASTER, PA 17603
Lancaster County (717) 544-8300
DR. KRISTEN E WONG MD
Internal Medicine (Advanced Heart Failure and Transplant Cardiology)
217 HARRISBURG AVE
LANCASTER, PA 17603
Lancaster County (717) 544-8300
DR. EDWARD WILLIAM SUPPLE M.D.
Internal Medicine (Cardiovascular Disease)
217 HARRISBURG AVE, THE HEART GROUP, LTD.
LANCASTER, PA 17603
Lancaster County (717) 397-5484

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 Tiffany Wisdom-goulbourne's NPI number?

The NPI number for Tiffany Wisdom-goulbourne is 1942041553. It was assigned to this individual provider in the NPPES registry on June 6, 2024.

Where is Tiffany Wisdom-goulbourne located?

Tiffany Wisdom-goulbourne practices at 217 Harrisburg Ave, Lancaster, PA 17603. The listed phone number is (717) 544-8300.

What is Tiffany Wisdom-goulbourne's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Tiffany Wisdom-goulbourne enrolled in Medicare?

Yes. Tiffany Wisdom-goulbourne 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.

What insurance does Tiffany Wisdom-goulbourne accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Tiffany Wisdom-goulbourne as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Tiffany Wisdom-goulbourne affiliated with any hospitals?

According to CMS data, Tiffany Wisdom-goulbourne is affiliated with Lancaster General Hospital.

When was this NPI record last updated?

The NPPES record for Tiffany Wisdom-goulbourne was last updated on May 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.