Jennifer Clysdale, MSN, CNP, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

58064 Issued in NM

Practice address

7850 Jefferson St NE Ste 300
Albuquerque, NM 87109-4314

Phone

(505) 884-1114

Fax

(505) 359-3010

NPI assigned

Jan 23, 2024

Last updated

Jan 23, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sage Neuroscience Center IncGroup PAC ID 5395840383, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.clysdale.1@26558.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sage Neuroscience Center Inc

  • Mental Health Counselor
  • Albuquerque, NM
  • NPI 1578644415
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1386405678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7850 JEFFERSON ST NE STE 300",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094314",
            "telephone_number": "505-884-1114",
            "fax_number": "505-359-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7850 JEFFERSON ST NE STE 300",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094314",
            "telephone_number": "505-884-1114",
            "fax_number": "505-359-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLYSDALE",
        "first_name": "JENNIFER",
        "credential": "MSN, CNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "58064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• C Douglas Cloud, DDS
• Kyle Anderson Clouse, DO
• Rajena Clouse
• Jamie Cloyes
• Shayne David Adam Clure, L.M.T.
• Cmvsleep
• CNR Medical Billing
• Eimee Lim Co, MD
• Wesley Co
• Coaches Korner & the Empowerment Center of New Mexico LLC

• Psychiatric/Mental Health Nurse Practitioner in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.