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

Meredith Sax Bourne, MD

Individual provider Family Medicine Physician · NPI 1134530504

Meredith Sax Bourne, MD is a Family Practice in Ithaca, New York. Graduated from University of Wisconsin School of Medicine in 2014, 12 years ago. Works from 3 locations and offers telehealth. Licensed in Minnesota and New York.

Years since qualifying
12
Trained at
University of Wisconsin School of Medicine
Licensed in
MN, NY
In the registry since
2014
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

720 Willow Ave
Ithaca, NY 14850-3215
Phone: (607) 219-4600
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 2810 Nicollet Ave, Minneapolis, MN 55408-4708 — (612) 873-6963
  • 3850 Park Nicollet Blvd, St Louis Park, MN 55416-2527 — (952) 993-3340

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 317095 (NY)
Family Medicine Physician Taxonomy 207Q00000X · Licence 59664 (MN)

Record details

NPI number1134530504
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 19, 2014
Last updated in NPPESDecember 8, 2022
Certification dateDecember 8, 2022
Mailing address1 Guthrie Sq, Sayre, PA 18840-1625

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Also practisesOBSTETRICS/GYNECOLOGY
Medical schoolUNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Graduated 2014 (12 years in practice)
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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