Oneil Anthony Goulbourne, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F345196-01 Issued in NY

Practice address

10 Fowler Ave
Ossining, NY 10562-1918

Phone

(914) 539-5080

NPI assigned

Dec 30, 2019

Last updated

Dec 30, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sun River Health Inc.Group PAC ID 6608783568, 246 clinicians

Divinity Medical Services PLLCGroup PAC ID 5193030245, 92 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Divinity Medical Services PLLC

  dba AFC Urgent Care Yorktown

  • Urgent Care Clinic/Center
  • Yorktown Heights, NY
  • NPI 1497159560
  Medicare reassignment Care Compare group NPD
• Sun River Health Inc

  • Federally Qualified Health Center (FQHC)
  • Amenia, NY
  • NPI 1568526838
  Medicare reassignment Care Compare group NPD
• Delaware River Medicine, PLLC

  • Emergency Medicine Physician
  • Port Jervis, NY
  • NPI 1457987521
  Medicare reassignment NPD
• Park Hill Emergency Physician Services

  • Emergency Medicine Physician
  • Yonkers, NY
  • NPI 1396123360
  Medicare reassignment NPD
• Urgent Care Physician of New York-Hartsdale PLLC

  dba Afc Urgent Care

  • Urgent Care Clinic/Center
  • Bronx, NY
  • NPI 1770885808
  Medicare reassignment NPD
• Sun River Health Inc.

  • Federally Qualified Health Center (FQHC)
  • Peekskill, NY
  • NPI 1619969458
  NPD

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

{
    "created_epoch": "1577664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1649819269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 FOWLER AVE",
            "city": "OSSINING",
            "state": "NY",
            "postal_code": "105621918",
            "telephone_number": "914-539-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 FOWLER AVE",
            "city": "OSSINING",
            "state": "NY",
            "postal_code": "105621918",
            "telephone_number": "914-539-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULBOURNE",
        "first_name": "ONEIL",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-30",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F345196-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Gizzi, COTA/L
• Robert T Goldman, MD
• Sarah M Gonel
• Veronica Lisette Gonzalez, PHARM D
• Catharine M Gorycki, MSED SPED
• Michael Thomas Grant, RPH
• Nancy J Grant, LMHC
• Tzivya Green
• Judy Guariglia, FNP
• Katherine Doralyn Guerra, LPN

• Family Nurse Practitioner in Ossining, NY
• Providers in Ossining, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; 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.