Individual provider Active NPI

Nicole Elise Clifton, M.D.

  • Pediatrics Physician
  • San Antonio, TX
National Provider Identifier
1659765949
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
T1329 Issued in TX
Practice address
333 N Santa Rosa
San Antonio, TX 78207-3108
Phone
(210) 704-2011
NPI assigned
Mar 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X DR.0060534 CO
Hospitalist Physician 208M00000X DR.0060534 CO
Hospitalist Physician 208M00000X T1329 TX
Pediatrics Physician 208000000X T1329 TX Primary

Addresses

Primary practice location

333 N Santa Rosa
San Antonio, TX 78207-3108

Mailing address

315 N San Saba Ste 1135
San Antonio, TX 78207-3255
Phone (210) 704-3030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210601002813 TX Practitioner - Pediatric Medicine 4486975414 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0060534COMDHospitalist Physician
T1329TXMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine Pediatrics CurrentSince May 14, 2021 Accepting new patients
Christus Santa Rosa Health Care Corporation Past Accepting new patients

Locations

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

333 N Santa Rosa
San Antonio, TX 78207
Phone (210) 704-2190

Interoperability endpoints

  • Direct secure messaging: nclifton411401@christushealth.direct-ci.net

Organizations & group practices 2

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": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1659765949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 N SAN SABA STE 1135",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073255",
            "telephone_number": "210-704-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N SANTA ROSA",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073108",
            "telephone_number": "210-704-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFTON",
        "first_name": "NICOLE",
        "middle_name": "ELISE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-24",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "DR.0060534",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CO",
            "license": "DR.0060534",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "T1329",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "T1329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.