Clyde Corwin Clybourn, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

M7914 Issued in TX

Practice address

1211B E Cliff Dr
El Paso, TX 79902-4734

Phone

(915) 591-6226

Fax

(915) 308-9433

NPI assigned

Oct 18, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal MedicineAlso: General Practice

Education

Jefferson Medical College of Thomas Jefferson University, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Conviva Medical Center Management of Texas, P.a.Group PAC ID 8729302278, 146 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: clyde.clybourn@conviva.eclinicaldirectplus.com
• Direct secure messaging: clyde.clybourn.1@16730.direct.athenahealth.com
• Direct secure messaging: clyde.clybourn.1@29601.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Conviva Medical Center Management of Texas, P.a.

  • Internal Medicine Physician
  • Live Oak, TX
  • NPI 1770988990
  Medicare reassignment Care Compare group NPD
• Hospitalist Medicine Physicians of Texas, PLLC

  • Internal Medicine Physician
  • Humble, TX
  • NPI 1629307095
  Medicare reassignment NPD
• Lonestar Hospital Medicine Associates, PA

  • Hospitalist Physician
  • Mansfield, TX
  • NPI 1518237429

  Internal Medicine

  Medicare reassignment NPD
• Centerwell Senior Primary Care (SC) PC

  • Internal Medicine Physician
  • Greenville, SC
  • NPI 1376907790
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1043391758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263168",
            "telephone_number": "844-630-0700",
            "fax_number": "877-374-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211B E CLIFF DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799024734",
            "telephone_number": "915-591-6226",
            "fax_number": "915-308-9433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10435 Vista Del Sol Dr",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799257920",
            "country_code": "US",
            "telephone_number": "915-591-6229",
            "fax_number": "915-206-6385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLYBOURN",
        "first_name": "CLYDE",
        "middle_name": "CORWIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M7914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "714478",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193932408",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clyde.clybourn@conviva.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1211B E Cliff Dr",
            "city": "El Paso",
            "state": "TX",
            "country_code": "US",
            "postal_code": "799024734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cloudview Home Health Agency, Inc.
• Cloudview Hospice LLC
• Perla Patricia Clouse
• Jeremy D Clowe, PHARMD.
• Club de Actividades Su Casa
• Cna Medical Care PLLC
• Cna Nursing Services Inc
• Cna Nursing Services Inc.
• CNV Adult Day Care LLP
• Allyssa Co, ATC

• Internal Medicine Physician in El Paso, TX
• Providers in El Paso, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.