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MRS. ALISA STEPHANIE GOULBOURNE-SCOTT PA-C
NPI 1942428255
Physician Assistant in Ridgewood, NJ

Active since April 23, 2007PECOS Enrolled
19 HENRIETTA CT, RIDGEWOOD, NJ 07450(201) 670-7498 Get Directions Write a Review

NPPES record last updated: September 14, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Alisa Stephanie Goulbourne-scott Pa-c NPPES

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

MRS. ALISA STEPHANIE GOULBOURNE-SCOTT PA-C (NPI 1942428255) is an individual physician assistant in Ridgewood, New Jersey, licensed in New York (0041901) and active in the NPI registry since April 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1942428255
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMRS. ALISA STEPHANIE GOULBOURNE-SCOTTCredential: PA-C
Location Address19 HENRIETTA CTRidgewood, NJ 07450-2938
Mailing Address19 Henrietta CtRidgewood, NJ 07450-2938 · (201) 670-7498
Phone(201) 670-7498
Sole ProprietorYes
Enumeration DateApril 23, 2007
Last NPPES UpdateSeptember 14, 2007
✔ NPI 1942428255 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 NY · 0041901
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.
19 HENRIETTA CT, Ridgewood, NJ 07450
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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 (PECOS)

Mrs. Alisa Stephanie Goulbourne-scott Pa-c 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07450 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
$98.09 typical visit price
range $63.84 – $190.92
Typical copayment $24.52 (range $15.96 – $47.73)
Most-billed visit code 99203
Established Patient
$79.09 typical visit price
range $20.97 – $155.92
Typical copayment $19.77 (range $5.24 – $38.98)
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.

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 Alisa Goulbourne-scott's NPI number?

The NPI number for Alisa Goulbourne-scott is 1942428255. It was assigned to this individual provider in the NPPES registry on April 23, 2007.

Where is Alisa Goulbourne-scott located?

Alisa Goulbourne-scott practices at 19 Henrietta Ct, Ridgewood, NJ 07450. The listed phone number is (201) 670-7498.

What is Alisa Goulbourne-scott's specialty?

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

Is Alisa Goulbourne-scott enrolled in Medicare?

Yes. Alisa Goulbourne-scott is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Alisa Goulbourne-scott was last updated on September 14, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.