Tompkins County
A Medicare group practice based in Ithaca, NY: 2 NPIs enrolled under one PECOS associate control ID (PAC ID 0143210443), with 19 clinicians.
Medicare enrollment
Medicare enrollment files- PAC ID
- 0143210443
- Provider type
- Part B Supplier - Clinic/Group Practice
- Enrolled in
- NY
- Enrollments
- 2
- Group size
- 19 clinicians
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Practice locations
- 2
Enrollment records 2
| Enrollment ID | State | Provider type | NPI |
|---|---|---|---|
| O20101004001295 | NY | Part B Supplier - Clinic/Group Practice | 1306995642 |
| O20040518000222 | NY | Part B Supplier - Clinic/Group Practice | 1588686596 |
NPIs in this group 2
NPPES NPI RegistryThese NPI records belong to the same enrolled organization. Each has its own page.
-
Tompkins County
- State or Local Public Health Clinic/Center
- Ithaca, NY
- NPI 1306995642
-
Tompkins County
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Ithaca, NY
- NPI 1588686596
Practice locations
- Ithaca, NY2
Clinicians 19
Clinicians who reassign their Medicare benefits to this group (19) or whom Care Compare lists as members (19).
-
Anne Simone Bartone
- Psychiatric/Mental Health Nurse Practitioner
- Ithaca, NY
- NPI 1700496155
-
Emilee Cool, LMSW
- Mental Health Counselor
- Ithaca, NY
- NPI 1962915561
-
Mi Jin Doe
- Psychiatric/Mental Health Nurse Practitioner
- Binghamton, NY
- NPI 1205268166
-
Jennifer Leigh Forte, LCSW
- Clinical Social Worker
- Ithaca, NY
- NPI 1114280625
-
Michelle Lynn Fulkerson, MHC
- Mental Health Counselor
- Ithaca, NY
- NPI 1457197683
-
Casey M Gallagher-Licitra, RN, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Ithaca, NY
- NPI 1215439336
-
James Leonard Haines-Burnham, LCSW-R
- Clinical Social Worker
- Ithaca, NY
- NPI 1699894998
-
Brenda Leigh Hill, LCSW
- Clinical Social Worker
- Ithaca, NY
- NPI 1093142499
-
Megan Anne Hogan, LCSW
- Clinical Social Worker
- Ithaca, NY
- NPI 1144994021
-
William A Klepack, M.D.
- Family Medicine Physician
- Dryden, NY
- NPI 1417902693
-
Carl Kueffer
- Clinical Social Worker
- Ithaca, NY
- NPI 1588172803
-
Gerard P Lippert, MD
- Psychiatry Physician
- Ithaca, NY
- NPI 1013955152
-
Maranda McFadden, LCSW
- Clinical Social Worker
- Cortland, NY
- NPI 1316420144
-
Katie Peters
- Clinical Social Worker
- Ithaca, NY
- NPI 1073088621
-
Sarah Jane Post, LCSW
- Clinical Social Worker
- Ithaca, NY
- NPI 1205468758
-
Heather Sanford, LCSW
- Clinical Social Worker
- Ithaca, NY
- NPI 1497293245
-
Chloe Schroeder
- Clinical Social Worker
- Ithaca, NY
- NPI 1700550100
-
Elisa Marie Crystal Wang, MD
- Psychiatry Physician
- Ithaca, NY
- NPI 1942615646
-
Nicole Williams
- Clinical Social Worker
- Ithaca, NY
- NPI 1831729359
Sources for this page
- Medicare Fee-For-Service Public Provider Enrollment: the enrollments, PAC ID, practice locations and benefit reassignments.
- Care Compare Doctors and Clinicians: group membership, group size and the name CMS shows patients.
- NPPES NPI Registry: the names and addresses of the NPIs above.