NPIMap

Organization Active NPI

Clifton-Fine Healthcare Corporation

Doing business as Clifton-Fine Hospital

  • Rural Acute Care Hospital
  • Star Lake, NY
National Provider Identifier
1235184649
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
Legal business name
CLIFTON-FINE HEALTHCARE CORPORATION
Doing business as
Clifton-Fine Hospital
Practice address
1014 Oswegatchie Trail Rd
Star Lake, NY 13690-3143
Phone
(315) 848-3351
Fax
(315) 848-2314
NPI assigned
May 23, 2006
Last updated
Oct 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Authorized official

Name
Ms. Dierdra Sorrell
Title
Ceo
Phone
(315) 848-4260

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Acute Care Hospital 282NR1301X Primary

Addresses

Primary practice location

1014 Oswegatchie Trail Rd
Star Lake, NY 13690-3143

Mailing address

1014 Oswegatchie Trail Rd
Star Lake, NY 13690-3143
Phone (315) 848-3351

Other identifiers 1

IdentifierTypeStateIssuer
02994847MedicaidNY

Other names 1

  • Clifton-Fine Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040511001168 NY Part B Supplier - Clinic/Group Practice 9739090382 Receives reassigned benefits from 29 practitioners
Practice locations: Star Lake, NY
O20241016001244 NY Part A Provider - Rural Emergency Hospital (Reh) 9739090382 Practice locations: Star Lake, NY

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1235184649. Details of each certification follow.

Hospital certification: CCN 330799

Legal name
CLIFTON-FINE HEALTHCARE CORPORATION
Certification status
Active
Provider type (POS)
Hospital – Rural emergency hospital
Participating since
Nov 12, 2024
Last certification
Nov 12, 2024
Beds
20
Ownership / control type
Other
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 2013 in NY
Enrollment address
1014 Oswegatchie Trail Rd
Star Lake, NY 13690-3143
Main/Primary Hospital Location

Hospital certification: CCN 331307

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CLIFTON-FINE HOSPITAL
Certification status
Terminated Other: provider status change, Nov 11, 2024
Provider type (POS)
Hospital – Critical access hospital
Participating since
Sep 29, 2000
Last certification
Dec 5, 2019
Beds
20
Ownership / control type
Private (not for profit)
Facility address
1014 Oswegatchie Trail
Star Lake, NY 13690

Care Compare: Hospital

Medicare Care Compare
Listed as
Clifton-Fine HospitalCCN 330799 · All quality measures
Type
Rural Emergency Hospital
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0693940Clifton-Fine Hospital Laboratory1014 Oswegatchie Trail, Star Lake, NY 13690ComplianceMar 26, 2027

National Provider Directory

National Provider Directory

Locations

1012 Oswegatchie Trail Rd
Star Lake, NY 13690
Phone (315) 848-3260

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
John Wheeler Individual Other Sep 17, 2024
John Burns Individual Other Sep 17, 2024
Chris Hochgraf Individual Corporate DirectorDirector of Revenue Cycle Sep 17, 2024
Dierdra D Sorrell Individual Corporate OfficerCeo Sep 17, 2024
Operational/Managerial ControlCeo Sep 17, 2024
Majonica Drake Individual Other Sep 17, 2024
Maxine a Briggs Individual Corporate OfficerCfo Sep 17, 2024
Allen Ditch Individual Other Sep 17, 2024
Leeann Short Individual Other Sep 17, 2024
Sadie Hall Individual Other Sep 17, 2024
David Daut Individual Other Sep 17, 2024
Halsey Bagg Individual Other Sep 17, 2024
Thomas H Carman Individual Other Sep 17, 2024
Thomas Sauter Individual Other Sep 17, 2024

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 29

Affiliated clinicians 20

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761177600000",
    "number": "1235184649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 OSWEGATCHIE TRAIL RD",
            "city": "STAR LAKE",
            "state": "NY",
            "postal_code": "136903143",
            "telephone_number": "315-848-3351",
            "fax_number": "315-848-2314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 OSWEGATCHIE TRAIL RD",
            "city": "STAR LAKE",
            "state": "NY",
            "postal_code": "136903143",
            "telephone_number": "315-848-3351",
            "fax_number": "315-848-2314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIFTON-FINE HEALTHCARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A",
        "authorized_official_last_name": "SORRELL",
        "authorized_official_first_name": "DIERDRA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "315-848-4260",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02994847",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clifton-Fine Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Star Lake, NY

Sources for this page

Verify at the official NPI Registry.