Individual provider Active NPI

Patrick Clifford, M.D.

  • Obstetrics & Gynecology Physician
  • Burlington, VT
National Provider Identifier
1720036783
Registry record updated Feb 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
0420007412 Issued in VT
Practice address
96 Colchester Ave
Burlington, VT 05401-1417
Phone
(802) 658-0505
NPI assigned
May 4, 2006
Last updated
Feb 4, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 0420007412 VT Primary

Addresses

Primary practice location

96 Colchester Ave
Burlington, VT 05401-1417

Mailing address

96 Colchester Ave
Burlington, VT 05401-1417
Phone (802) 658-0505

Other identifiers 2

IdentifierTypeStateIssuer
0009275MedicaidVT
160018796OtherVTRAIL ROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080408000100 VT Practitioner - Obstetrics/Gynecology 0547347171 Reassigns benefits to 2 organizations
I20191023000427 NY Practitioner - Obstetrics/Gynecology 0547347171 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
296475NYMDLicensed Practical Nurse
0420007412VTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Center, Inc CurrentSince Jun 22, 2018 Accepting new patients
Champlain Valley Physicians Hospital Medical Center CurrentSince Sep 4, 2019 Accepting new patients
Northwestern Medical Center, Inc. Current Accepting new patients
Northwestern Medical Center Inc CurrentSince Jun 22, 2018 Accepting new patients
University of Vermont Medical Center Inc Obstetrics & Gynecology CurrentSince Mar 18, 2022 Accepting new patients

Locations

75 Beekman St
Plattsburgh, NY 12901
Phone (518) 562-7100

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

133 Fairfield St
Saint Albans, VT 05478
Phone (802) 524-1227

3 Crest Rd
Saint Albans, VT 05478
Phone (802) 524-4554

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359936000000",
    "number": "1720036783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011417",
            "telephone_number": "802-658-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011417",
            "telephone_number": "802-658-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFFORD",
        "first_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2013-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VT",
            "license": "0420007412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009275",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "160018796",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.