Madeline Clisham, CRNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

SP017475 Issued in PA

Practice address

1787 Sentry Pkwy W Ste 405
Blue Bell, PA 19422-2239

Phone

(877) 868-4827

NPI assigned

Aug 28, 2017

Last updated

Dec 13, 2022By 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

Other names 1

• Madeline Martin Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clinical Specialty AssociatesGroup PAC ID 5799295853, 165 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Chester County Hospital Hospital, West Chester, PA, CCN 390179

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: referral@vitas.direct.kno2fy.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.

• Clinical Specialty Associates

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Bala Cynwyd, PA
  • NPI 1184431900
  Medicare reassignment Care Compare group NPD
• Clinical Care Associates of the University of Pennsylvania Health

  • Internal Medicine Physician
  • Radnor, PA
  • NPI 1972682995
  Medicare reassignment NPD
• Vitas Solutions Inc

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Miramar, FL
  • NPI 1861666497

  PA

  Medicare reassignment NPD
• Clinical Care Associates of the University of Pennsylvania Health

  • Psychologist
  • West Chester, PA
  • NPI 1649940107
  NPD
• Clinical Care Associates of the University of Pennsylvania Health Syst

  • Hospitalist Physician
  • Bala Cynwyd, PA
  • NPI 1790737468
  NPD
• Clinical Specialty Associates

  • Infectious Disease Physician
  • Bala Cynwyd, PA
  • NPI 1932992609
  NPD

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

• Chester County Hospital

  • General Acute Care Hospital
  • West Chester, PA
  • NPI 1356333579
  Care Compare affiliation

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

{
    "created_epoch": "1503878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1699292854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1787 SENTRY PKWY W STE 405",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194222239",
            "telephone_number": "877-868-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1787 SENTRY PKWY W STE 405",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194222239",
            "telephone_number": "877-868-4827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLISHAM",
        "first_name": "MADELINE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-28",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP017475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "referral@vitas.direct.kno2fy.com",
            "affiliation": "Y",
            "affiliationName": "VITAS Solutions Inc",
            "address_1": "3720 Executive Way",
            "city": "Miramar",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330253946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MADELINE",
            "last_name": "MARTIN",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adam Terrence Chrusch, M.D.
• Citizens Health and Wellness
• Sharnae Clement
• Cline Medical Supplies, LLC
• Breanna Clinton
• April Colbert, PSYD
• Justin Colbert
• Columbus Medical Services, LLC
• Columbus Medical Services, LLC (The Columbus Organization)
• Comfort Hospice Inc

• Gerontology Nurse Practitioner in Blue Bell, PA
• Providers in Blue Bell, PA by specialty
• Gerontology Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; 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.