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Active NPI 1114657228 Individual Practitioner Female Practitioner

Samantha Goutermout , NP

Nurse Practitioner • Fulton, NY

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Samantha Goutermout, NP is a certified Nurse Practitioner practicing in Fulton, NY. With approximately 4 years of clinical experience since graduating from State University Of Ny Upstate Medical University in 2022, Samantha Goutermout delivers high-quality medical care to the local community at 522 S 4TH ST.

Samantha Goutermout is affiliated with Physician Care Pc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

522 S 4th St

Fulton, NY 130692946

Telephone 3155923930
Fax 3155923932
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

State University Of Ny Upstate Medical University

Graduation Year

2022

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Fulton, NY

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
4 Yrs Matches City Avg
City Avg: 4.0 Yrs
State Avg: 13.6 Yrs
Regional Practice Density
2 Specialists

Practicing in Fulton, NY (3155 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
58.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Goutermout (4 Years) 4 Yrs
Fulton Specialty Average (4.0 Years) 4.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
35 19 $244.00 $103.66
99213 Established patient office or other outpatient visit, typically 15 minutes
31 25 $169.58 $69.77

Medical Specialties & State Licenses

CMS Verified: 2023-03-29
Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License NY 717095

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Hospital & Practice Group Affiliations

Physician Care Pc

522 S 4th St, Fulton, NY 130692918

Phone: 3155923930

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
Dr. Vandana Patil , MD

Family Medicine

NPI 1285735027

Doctor of Medicine (M.D.)

Casey Donovan

Nurse Practitioner - Family

NPI 1326919424
Kimberly Pompo , PA

Physician Assistant

NPI 1568144780

Physician Assistant

Dr. Andrew Rogall , MD

Family Medicine

NPI 1689025710

Doctor of Medicine (M.D.)

Brandon Weaver , PA

Physician Assistant - Medical

NPI 1730220500

Physician Assistant

NPI 1831152578

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active June 13, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location June 13, 2022

Registered at 522 S 4TH ST, FULTON, NY 130692946 (Tel: 3155923930)

📍
Updated Business Mailing Address June 13, 2022

Registered at 110 W 6TH ST, OSWEGO, NY 131262507 (Tel: 3153495511)

👤
Provider Name / Credentials Updated June 13, 2022

Recorded as SAMANTHA GOUTERMOUT, NP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 13, 2022

Nurse Practitioner (License #717095 in NY)

🟢
Initial NPI Registration & Enumeration June 13, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1114657228
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 13, 2022
Last Update: March 29, 2023
Sole Proprietor: No

Mailing Address

110 W 6th St

Oswego, NY 131262507

Phone: 3153495511

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.