Individual provider Active NPI

Sara Elizabeth Bourgeois, FNP

  • Family Nurse Practitioner
  • Barneveld, NY
National Provider Identifier
1306599139
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
349038 Issued in NY
Practice address
7980 State Route 12
Barneveld, NY 13304-2536
Phone
(315) 624-8440
NPI assigned
Feb 1, 2022
Last updated
Jul 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 349038 NY Primary
Registered Nurse 163W00000X 688583 NY

Addresses

Primary practice location

7980 State Route 12
Barneveld, NY 13304-2536

Mailing address

111 Hospital Dr
Utica, NY 13502-2517
Phone (315) 624-6100

Other names 1

  • Sara Elizabeth Moore Former name

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220322001800 NY Practitioner - Nurse Practitioner 0840685244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MVHS IncGroup PAC ID 2769380252, 330 clinicians

Practice addresses (Care Compare)

1676 Sunset Ave
Utica, NY 13502-5416
Phone (315) 625-6000

7980 State Route 12
Barneveld, NY 13304-2536
Phone (315) 624-8440

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.28 of 100Reported as group
Quality
75.06
Promoting interoperability
100
Improvement activities
40
Cost
69.26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
688583NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
MVHS Inc CurrentSince Apr 1, 2022 Accepting new patients
MVHS Inc CurrentSince Apr 1, 2022 Accepting new patients

Locations

7980 State Route 12
Barneveld, NY 13304
Phone (315) 624-8440

1656 Champlin Ave
New Hartford, NY 13413
Phone (315) 624-6222

111 Hospital Dr
Utica, NY 13502
Phone (315) 801-8534

1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567

2209 Genesee St
Ofc
Utica, NY 13501
Phone (315) 801-3282

Interoperability endpoints

  • Direct secure messaging: sbourgeois10890@mvhealthsystem.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1643673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1306599139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 HOSPITAL DR",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135022517",
            "telephone_number": "315-624-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7980 STATE ROUTE 12",
            "city": "BARNEVELD",
            "state": "NY",
            "postal_code": "133042536",
            "telephone_number": "315-624-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURGEOIS",
        "first_name": "SARA",
        "middle_name": "ELIZABETH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-01",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "349038",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "688583",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "MOORE",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Barneveld, NY

Sources for this page

Verify at the official NPI Registry.