Anna Mary Clifford, PNP

Individual provider Active NPI Pediatric Nurse Practitioner · Horseheads, NY

NPI 1205320587 · NPPES record last updated Mar 24, 2021

Key facts

NPI
1205320587
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Nurse Practitioner 363LP0200X
License
382862 (NY)
Practice address
3344 Chambers Rd Ste 100
Horseheads, NY 14845-1403
Phone
(607) 742-2264
NPI assigned
Jun 19, 2018
Sex
Female
Sole proprietor
No

Organizations & group practices 4

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20210129002020 NY Practitioner - Nurse Practitioner 0143634360 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group, P.C. Current
since Feb 1, 2021
Accepting new patients
Guthrie Medical Group, P.C. Current
since Feb 1, 2021
Accepting new patients
Buttermilk Falls Pediatrics Past Accepting new patients
Guthrie Medical Group PC Past Accepting new patients

Locations

130 Center Way
Corning, NY 14830
Phone (607) 936-9971

3344 Chambers Rd
Horseheads, NY 14845
Phone (607) 734-2264

3344 Chambers Rd
Ste 100
Horseheads, NY 14845
Phone (607) 734-2264

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

Interoperability endpoints

  • Direct secure messaging: aclifford49674@direct-guthrie.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 382862 NY Yes

Addresses

Primary practice location

3344 Chambers Rd Ste 100
Horseheads, NY 14845-1403

Mailing address

1 Guthrie Sqare
Sayre, NY 18840-1625
Phone (570) 888-5858

Other names

  • Anna Mary Tesillo Former name

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address aclifford49674@direct-guthrie.org Direct

Other providers in Horseheads, NY

All providers in Horseheads, NY · Pediatric Nurse Practitioner in New York

Sources for this page

Verify at the official NPI Registry.