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

Samantha Goutermout, NP

Individual provider Nurse Practitioner · NPI 1114657228

Samantha Goutermout, NP is a Nurse Practitioner in Fulton, New York. Graduated from State University of Ny Upstate Medical University in 2022, 4 years ago. Practices with Physician Care PC, a 77-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
4
Trained at
State University of Ny Upstate Medical University
Licensed in
NY
In the registry since
2022
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

See every abbreviation used in this directory →

Practice location Address checks out

522 S 4th St
Fulton, NY 13069-2946
Phone: (315) 592-3930
Fax: (315) 592-3932
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 717095 (NY)

Record details

NPI number1114657228
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedJune 13, 2022
Last updated in NPPESMarch 29, 2023
Certification dateMarch 29, 2023

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolSTATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Graduated 2022 (4 years in practice)
Group practice Physician Care Pc — 77 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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