Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Caroline Samantha Bourassa, CPNP

Individual provider Pediatric Nurse Practitioner · NPI 1760968408

Caroline Samantha Bourassa, CPNP is a Nurse Practitioner in New York, New York. Qualified in 2018, 8 years ago. Practices with Memorial Pediatric Group, a 39-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
8
Licensed in
NY
In the registry since
2018
What do these letters mean?
CPNP — Certified Pediatric Nurse Practitioner
A nurse practitioner certified in paediatrics.

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Practice location Address checks out

1275 York Ave
New York, NY 10065-6007
Phone: (212) 639-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Nurse Practitioner (primary) Taxonomy 363LP0200X · Licence 382879 (NY)

Record details

NPI number1760968408
Entity typeIndividual (Type 1)
GenderFemale
Credentials CPNP
Sole proprietorNo
NPI enumeratedJuly 16, 2018
Last updated in NPPESMarch 16, 2022
Certification dateMarch 16, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Memorial Pediatric Group — 39 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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