Individual provider Active NPI

Clifford A Mevs, M.D.

  • Pediatrics Physician
  • Staten Island, NY
National Provider Identifier
1063486934
Registry record updated Dec 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
160103 Issued in NY
Practice address
148 New Dorp Lane
2ND Floor
Staten Island, NY 10306
Phone
(718) 980-5437
Fax
(718) 979-2653
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 160103 NY Primary

Addresses

Primary practice location

148 New Dorp Lane
2ND Floor
Staten Island, NY 10306

Mailing address

148 New Dorp Lane
2ND Floor
Staten Island, NY 10306
Phone (718) 980-5437

Other identifiers 1

IdentifierTypeStateIssuer
01214337MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20040527001367 NY Practitioner - Pediatric Medicine 5991786600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University Central del Caribe Escuela de Medicina, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allied Physicians Group, PLLCGroup PAC ID 0042433146, 19 clinicians

Practice addresses (Care Compare)

2 Teleport Dr
Suite 107
Staten Island, NY 10311-1004
Phone (718) 980-5437

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Physicians Group, PLLC Pediatrics CurrentSince Feb 25, 2019 Accepting new patients
Richmond University Medical Center Past Accepting new patients

Locations

34 Commerce Ave
Riverhead, NY 11901
Phone (631) 591-3000

2 Teleport Dr
Ste 107
Staten Island, NY 10311
Phone (718) 980-5437

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: clifford.mevs.1@24004.direct.athenahealth.com
  • Direct secure messaging: clifford.mevs.1@29151.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385942400000",
    "number": "1063486934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 NEW DORP LANE",
            "address_2": "2ND FLOOR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10306",
            "telephone_number": "718-980-5437",
            "fax_number": "718-979-2653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 NEW DORP LANE",
            "address_2": "2ND FLOOR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10306",
            "telephone_number": "718-980-5437",
            "fax_number": "718-979-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEVS",
        "first_name": "CLIFFORD",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2013-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "160103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01214337",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.