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Individual provider Active NPI

Noah C Bourne, DNP, AGPCNP-BC

  • Adult Health Nurse Practitioner
  • Orchard Park, NY
National Provider Identifier
1194508002
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
311374 Issued in NY
Practice address
3055 Southwestern Blvd Ste 100
Orchard Park, NY 14127-1231
Phone
(716) 675-2500
NPI assigned
Aug 15, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 311374 NY Primary

Addresses

Primary practice location

3055 Southwestern Blvd Ste 100
Orchard Park, NY 14127-1231

Mailing address

3055 Southwestern Blvd Ste 100
Orchard Park, NY 14127-1231
Phone (716) 675-2500

Other practice location 1

3500 Sheridan Dr Side Entrance
Amherst, NY 14226-1548
Phone (716) 204-4263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231214003216 NY Practitioner - Nurse Practitioner 2961851076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York at Buffalo School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Buffalo Rheumatology and Medicine PLLC 11 clinicians

Practice addresses (Care Compare)

3055 Southwestern Blvd
Suite 100
Orchard Park, NY 14127-1231
Phone (716) 675-2500

Hospital & facility affiliations

  • Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078
  • Kaleida Health Hospital, Buffalo, NY, CCN 330005
  • Mercy Hospital of Buffalo Hospital, Buffalo, NY, CCN 330279
  • Kenmore Mercy Hospital Hospital, Kenmore, NY, CCN 330102
  • Olean General Hospital Hospital, Olean, NY, CCN 330103

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
311374NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Buffalo Rheumatology and Medicine PLLC CurrentSince Aug 27, 2023 Accepting new patients
Buffalo Rheumatology and Medicine PLLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

3500 Sheridan Dr
Buffalo, NY 14226
Phone (716) 204-4263

3055 Southwestern Blvd
Ste 100
Orchard Park, NY 14127
Phone (716) 675-2500

Organizations & group practices 2

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1194508002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3055 SOUTHWESTERN BLVD STE 100",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271231",
            "telephone_number": "716-675-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3055 SOUTHWESTERN BLVD STE 100",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271231",
            "telephone_number": "716-675-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3500 Sheridan Dr Side Entrance",
            "address_purpose": "LOCATION",
            "city": "Amherst",
            "state": "NY",
            "postal_code": "142261548",
            "country_code": "US",
            "telephone_number": "716-204-4263",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOURNE",
        "first_name": "NOAH",
        "middle_name": "C",
        "credential": "DNP, AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "311374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.