Meredith Sax Bourne, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

317095 Issued in NY

Practice address

720 Willow Ave
Ithaca, NY 14850-3215

Phone

(607) 219-4600

NPI assigned

May 19, 2014

Sex

Female

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Guthrie Medical Group, P.C.

  • Multi-Specialty Clinic/Center
  • Corning, NY
  • NPI 1134178635

  NY

  Medicare reassignment NPD
• Guthrie Medical Group, P.C.

  • General Practice Physician
  • Sayre, PA
  • NPI 1245246644

  Family Medicine

  NPD
• Samg Inc

  • Primary Care Clinic/Center
  • Plymouth Meeting, PA
  • NPI 1760103881
  NPD (past)

Specialty

Family PracticeAlso: Obstetrics/Gynecology

Education

University of Wisconsin School of Medicine, 2014

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mbourne180264@direct-guthrie.org
• Direct secure messaging: meredith.bourne@591631039135748.direct.elationemr.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 8, 2022.

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1134530504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-888-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 WILLOW AVE",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148503215",
            "telephone_number": "607-219-4600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2810 Nicollet Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554084708",
            "country_code": "US",
            "telephone_number": "612-873-6963",
            "fax_number": "612-545-9259",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3850 Park Nicollet Blvd",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "554162527",
            "country_code": "US",
            "telephone_number": "952-993-3340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOURNE",
        "first_name": "MEREDITH",
        "middle_name": "SAX",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-19",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "59664",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "317095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Borotz
• Tammy Marie Borrelli, CASAC
• Amy Klingaman Boscia, O.D.
• Kristopher M Bosela, PT, DPT, OCS
• Sarah Botsford, MPT
• Madison Antionette Boutureira
• Alyssa G Bovalino, PA-C
• Sarah Marie Bower, OTR/L
• Katie Erin Bowers, DPT
• Kristiana Bowman

• All providers in Ithaca, NY
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.