Samantha Goutermout, NP in Fulton, NY - Medicare Nurse Practitioner

Samantha Goutermout, NP is a medicare enrolled "Nurse Practitioner" in Fulton, New York. Her current practice location is 522 S 4th St, Fulton, New York. You can reach out to her office (for appointments etc.) via phone at (315) 592-3930.

Samantha Goutermout is licensed to practice in New York (license number 717095) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1114657228.

Contact Information

	Samantha Goutermout, NP
	522 S 4th St, Fulton, NY 13069-2946
	(315) 592-3930
	(315) 592-3932

Map and Direction

Provider's Profile

Full Name	Samantha Goutermout
Gender	Female
Speciality	Nurse Practitioner
Location	522 S 4th St, Fulton, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1114657228
Provider Enumeration Date: 06/13/2022
Last Update Date: 03/29/2023

Medicare PECOS Information:

PECOS PAC ID: 7618350893
Enrollment ID: I20220822000854

Medical Identifiers

Medical identifiers for Samantha Goutermout such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1114657228	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	717095 (New York)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Samantha Goutermout allows following entities to bill medicare on her behalf.

Entity Name	Physician Care Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073868113 PECOS PAC ID: 9032367453 Enrollment ID: O20120910000593

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Samantha Goutermout is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Samantha Goutermout, NP 110 W 6th St, Oswego, NY 13126-2507 Ph: (315) 349-5511	Samantha Goutermout, NP 522 S 4th St, Fulton, NY 13069-2946 Ph: (315) 592-3930

Reviews and Comments

Nurse Practitioner Nurses in Fulton, NY

Mrs. Rebecca Dottolo, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 510 S 4th St, Fulton, NY 13069 Phone: 315-592-3500
Mrs. Cheryl Susan Martin-schroeder, M.S.N.,P.N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 63 S 1st St, Fulton, NY 13069 Phone: 315-598-6785 Fax: 315-592-3571
Shannon M Woods, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 98 N 2nd St, Fulton, NY 13069 Phone: 315-326-3555
Mrs. Joanne Lomber, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 941 S 1st St, Fulton, NY 13069 Phone: 315-593-1729
Ms. Claire Ann Vacca, N,P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 21 N 2nd St, Fulton, NY 13069 Phone: 315-598-7105 Fax: 315-598-4857
Kylie M. Lacey, N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 522 S 4th St, Suite 500, Fulton, NY 13069 Phone: 315-598-4740 Fax: 315-598-4719

Samantha Goutermout, NP - Medicare Nurse Practitioner in Fulton, NY