ELLIOTTE SCHAFER BOURNE (PA-C) – Physician Assistant, NPI 1366155442
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,853 PHYSICIAN ASSISTANT in MO
Provider Addresses for ELLIOTTE SCHAFER BOURNE (PA-C)
1000 Gw Ln
Waynesville, MO 655832339
Phone: (573) 774-2715
Fax: (573) 202-2410
Type: Location
1000 W 10th St
Rolla, MO 654012905
Phone: (573) 364-9000
Fax: (573) 426-2108
Type: Location
1050 W 10TH ST
ROLLA, MO 654012905
Phone: (573) 364-9000
Fax: (573) 426-2108
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $84.
Total Amount is formed as General ($84) + Research ($0) + Ownership ($0) = $84.
Last reported payment date: 2024-11-25 • Largest payer in this snapshot: Novo Nordisk Inc ($70).
Total Amount
$84
General + Research + Ownership
Payments
5
Total payment records
General Amount
$84
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-25
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $70 |
| AstraZeneca Pharmaceuticals LP | $14 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-02-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240228003686 | I | Physician Assistant | MO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 65583)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | MO | |
| - | MO | |
| - | MO | |
| Radiation Oncology | MO | |
| Otolaryngology, Plastic And Reconstructive Surgery, Allergy/Immunology | MO | |
| - | MO | |
| Nephrology, Internal Medicine, Hospitalist | MO | |
| - | MO | |
| Nurse Practitioner | MO | |
| Certified Nurse Midwife (Cnm) | MO |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.