Individual provider Active NPI

Jeffrey E Clemente, M.D.

  • Family Medicine Physician
  • Erie, PA
National Provider Identifier
1336477058
Registry record updated Jul 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD437546 Issued in PA
Practice address
3822 Colonial Ave
Erie, PA 16506-3826
Phone
(814) 833-5653
NPI assigned
Nov 19, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD437546 PA Primary

Addresses

Primary practice location

3822 Colonial Ave
Erie, PA 16506-3826

Mailing address

2860 Cardinal Dr
Erie, PA 16509-8032
Phone (814) 217-9349

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20180920000220 NJ Practitioner - Family Practice 3779627567 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD437546PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Urgent Care Medicine of New Jersey LLP CurrentSince Dec 1, 2021 Accepting new patients
Saint Vincent Medical Education and Research Institute Family Medicine Past Accepting new patients
Erie Physicians Network PC Past Accepting new patients

Locations

1210 Route 130 N
Ste 1438
Cinnaminson, NJ 08077
Phone (551) 313-0170

415 W Saint Georges Ave
Linden, NJ 07036
Phone (908) 925-0363

1 Harmon Plz
Ste 1010
Secaucus, NJ 07094

Interoperability endpoints

  • Direct secure messaging: jeffrey.clemente.1@24114.direct.athenahealth.com

Organizations & group practices 3

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": "1258588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310947200000",
    "number": "1336477058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 CARDINAL DR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165098032",
            "telephone_number": "814-217-9349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3822 COLONIAL AVE",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165063826",
            "telephone_number": "814-833-5653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTE",
        "first_name": "JEFFREY",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-19",
        "last_updated": "2011-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD437546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.