TIFFANY WISDOM-GOULBOURNE
NPI 1942041553
Nurse Practitioner - Acute Care in Lancaster, PA
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
Specialties & Licenses
Accepted Insurance
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
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.
Medicare Billing Reassignment
Medicare enrollment records show Tiffany Wisdom-goulbourne reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Lancaster, PA 17603
- Reassigned Medicare billing, Pennsylvania enrollment
- 64 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.
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, PAPhysician 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.
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.
LANCASTER, PA 17603
LANCASTER, PA 17603
LANCASTER, PA 17603
LANCASTER, PA 17603
LANCASTER, PA 17603
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.
Which organization bills Medicare for Tiffany Wisdom-goulbourne's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Tiffany Wisdom-goulbourne reassigns Medicare benefits to The Heart Group Of Lancaster General Health (Lancaster, PA). 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 Tiffany Wisdom-goulbourne's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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 17 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.
# Tiffany Wisdom-Goulbourne · NPI 1942041553
Acute Care physician in Lancaster, Pennsylvania. Individual provider, active in the CMS NPPES registry since June 6, 2024.
## Identity
- **NPI:** 1942041553 (Entity type: Individual)
- **Enumerated:** June 6, 2024
- **Primary specialty:** Nurse Practitioner - Acute Care · taxonomy 363LA2100X
- **State license:** SP029670 (Pennsylvania)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 217 HARRISBURG AVE, Lancaster, PA 17603-2964
- **Phone:** (717) 544-8300
## 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:** The Heart Group Of Lancaster General Health (NPI 1760793210, Lancaster, PA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** May 7, 2025
---
Source: [NPI Profile](https://npiprofile.com/npi/1942041553) · Data from the CMS NPPES public registry.