Individual provider Active NPI

Clotilde Balucani, M.D., PH.D.

  • Neurology Physician
  • Brooklyn, NY
National Provider Identifier
1487041604
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
300424 Issued in NY
Practice address
450 Clarkson Ave
Neurology Department, Suny Downstate Medical Center
Brooklyn, NY 11203-2012
Phone
(718) 270-2051
Fax
(718) 270-3840
NPI assigned
Apr 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 300424 NY Primary

Addresses

Primary practice location

450 Clarkson Ave
Neurology Department, Suny Downstate Medical Center
Brooklyn, NY 11203-2012

Mailing address

450 Clarkson Ave
Neurology Department, Suny Downstate Medical Center
Brooklyn, NY 11203-2012
Phone (718) 270-2051

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
I20210714003046 NY Practitioner - Neurology 2769884634 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

10201 66TH Rd
Forest Hills, NY 11375-2029
Phone (718) 830-4000

Hospital & facility affiliations

  • Lenox Hill Hospital Hospital, New York, NY, CCN 330119

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
300424NYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Aug 1, 2021 Accepting new patients
New York University CurrentSince Aug 1, 2021 Accepting new patients
North Shore-Lij Medical PC CurrentSince Oct 16, 2024 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

100 E 77th St
#2
New York, NY 10075
Phone (212) 434-2460

300 Community Dr
Plandome, NY 11030

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

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

Interoperability endpoints

  • Direct secure messaging: cbalucani66918@northwell.direct-ci.com
  • Direct secure messaging: cbalucani1050743@nychhc.direct-ci.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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1430006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1487041604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "address_2": "NEUROLOGY DEPARTMENT, SUNY DOWNSTATE MEDICAL CENTER",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "718-270-2051",
            "fax_number": "718-270-3840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "address_2": "NEUROLOGY DEPARTMENT, SUNY DOWNSTATE MEDICAL CENTER",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "718-270-2051",
            "fax_number": "718-270-3840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALUCANI",
        "first_name": "CLOTILDE",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-26",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "300424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.