CLIFFORD SEBASTIAN MD
NPI 1164409538
Internal Medicine - Cardiovascular Disease in Chester, NJ

Q: What is Clifford Sebastian's NPI number?

The NPI number for Clifford Sebastian is 1164409538. It was assigned to this individual provider in the NPPES registry on December 28, 2005.

Q: What is Clifford Sebastian's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Active since December 28, 2005PECOS EnrolledAccepts Medicare Assignment

78.11/100

CMS Quality Rating

415 ROUTE 24, SUITE E, CHESTER, NJ 07930(908) 879-1500 Get Directions Write a Review

NPPES record last updated: March 10, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

On this page

About Clifford Sebastian Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLIFFORD SEBASTIAN MD (NPI 1164409538) is an individual cardiovascular disease provider in Chester, New Jersey, licensed in New Jersey (25MA08227500) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, is affiliated with Hunterdon Medical Center, and is a graduate of Albany Medical College Of Union University (1999).

NPPES Registry Identity

NPI1164409538

Entity TypeIndividualMale

Primary Taxonomy207RC0000X

Provider Legal NameCLIFFORD SEBASTIANCredential: MD

Location Address415 ROUTE 24, SUITE EChester, NJ 07930-2920

Mailing Address415 Route 24, Suite EChester, NJ 07930-2920 · (908) 879-1500

Phone(908) 879-1500

Sole ProprietorNo

Medical School CMSAlbany Medical College Of Union UniversityGraduated 1999

Enumeration DateDecember 28, 2005

Last NPPES UpdateMarch 10, 2014

✔ NPI 1164409538 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

Licenses✔ Licensed in NJ · 25MA08227500✔ Licensed in RI · MD11951

Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

415 ROUTE 24, Chester, NJ 07930

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Other Identifiers 1

Medicare UPINH60820

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Clifford Sebastian Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4981797727

PECOS Enrollment IDI20070910000623

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 18

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

1,920 services681 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

586 services529 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

453 services379 patients

Injection, regadenoson, 0.1 mg J2785

Regadenoson injection, 0.1 mg, is a medication used to help visualize the heart during a stress test. It works by increasing blood flow in the arteries of the heart. It's injected into a vein and is generally well-tolerated.

368 services91 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

358 services78 patients

Ultrasound of both sides of head and neck blood flow 93880

An ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.

333 services328 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician 93015

An exercise or drug-induced heart stress test with ECG is a procedure performed by a doctor to assess how your heart responds to exertion. It involves monitoring your heart's electrical activity while you exercise or after medication is given to mimic exercise effects.

189 services185 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

112 services108 patients

Technetium tc-99m tetrofosmin, diagnostic, per study dose A9502

Technetium Tc-99m Tetrofosmin is a radiopharmaceutical used in diagnostic imaging. It helps highlight areas of concern in the heart by emitting signals captured by a special camera. This assists doctors in detecting heart conditions.

96 services93 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

94 services93 patients

Blood test, clotting time 85610

A clotting time blood test helps determine how quickly your blood forms clots, a process crucial to stop bleeding. During the test, a small blood sample is taken from your arm. The sample is then analyzed in a lab to see how long it takes for a clot to form.

90 services12 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

70 services59 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

52 services46 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

50 services50 patients

Ultrasound of aorta, vena cava, groin vessels or bypass grafts 93979

This procedure involves using sound waves to create images of your aorta, vena cava, groin vessels, or bypass grafts. It helps doctors check for issues like blockages or enlargements. It's non-invasive and painless.

45 services44 patients

Electrocardiogram (ecg) 2-day continuous with review and report by health care professional 93224

An Electrocardiogram (ECG) is a non-invasive test that records the electrical activity of your heart. In a 2-day continuous ECG, sensors attached to your chest monitor your heart's rhythm over 48 hours. A healthcare professional then reviews the data to identify any irregularities.

42 services41 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

41 services38 patients

Electrocardiogram (ecg) up to 30 days continuous with transmission of patient triggered events with review and report by health care professional 93229

An Electrocardiogram (ECG) is a test that records your heart's electrical activity for up to 30 days. You trigger a transmission if you feel symptoms, which is then reviewed by a healthcare professional. The report helps diagnose heart conditions.

40 services39 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Hunterdon Medical Center

Acute Care Hospitals · Flemington, NJ

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310005

Location2100 Wescott DriveFlemington, NJ 08822 · Hunterdon County

Birthing friendly

Morristown Medical Center

Acute Care Hospitals · Morristown, NJ

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310015

Location100 Madison AveMorristown, NJ 07960 · Morris County

Emergency services Birthing friendly

Saint Clare's Hospital/ Denville Campus

Acute Care Hospitals · Denville, NJ

3/5 CMS rating

OwnershipProprietary

CMS Certification Number310050

Location25 Pocono RoadDenville, NJ 07834 · Morris County

Emergency services Birthing friendly

Hackettstown Medical Center

Acute Care Hospitals · Hackettstown, NJ

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310115

Location651 Willow Grove StHackettstown, NJ 07840 · Warren County

Emergency services

St Luke's Hospital Bethlehem

Acute Care Hospitals · Bethlehem, PA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390049

Location801 Ostrum StreetBethlehem, PA 18015 · Northampton County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07930 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$144.86 typical visit price

range $63.84 – $190.92

Typical copayment $36.21 (range $15.96 – $47.73)

Most-billed visit code 99204

Established Patient

$79.09 typical visit price

range $20.97 – $155.92

Typical copayment $19.77 (range $5.24 – $38.98)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

78.11/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

74.25

Improvement Activities

Reported Quality Measures

Advance Care Plan

2%1,081 patients1/55-star benchmark: 100%

Breast Cancer Screening

8%426 patients1/55-star benchmark: 93%

Cervical Cancer Screening

8%295 patients1/55-star benchmark: 98%

Colorectal Cancer Screening

12%999 patients1/55-star benchmark: 88%

Controlling High Blood Pressure

89%1,026 patients4/55-star benchmark: 91%

Coronary Artery Disease (CAD): Antiplatelet Therapy

71%374 patients3/55-star benchmark: 100%

Diabetes Mellitus: Diabetic Foot and Ankle Care, Peripheral Neuropathy - Neurological Evaluation

1%502 patients1/55-star benchmark: 100%

Diabetes: Eye Exam

2%413 patients1/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

37%413 patients3/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

97%4,180 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

3%1,031 patients1/55-star benchmark: 100%

HIV Screening

1%694 patients1/55-star benchmark: 60%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

28%1,665 patients2/55-star benchmark: 98%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

4%1,548 patients1/55-star benchmark: 97%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

35%2,310 patients3/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 48% · 1,306 patients

Patients screened: 49% · 1,306 patients

29%24 patients2/55-star benchmark: 100%

Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling

Patients screened: 25% · 1,181 patients

25%1,181 patients

Screening for Osteoporosis for Women Aged 65-85 Years of Age

2%438 patients1/55-star benchmark: 98%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

80%1,155 patients4/55-star benchmark: 91%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 1% · 1,039 patients

Patients totalRate: 3% · 1,074 patients

3%1,074 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAWRENCE CHARLES ANTONUCCI MD

Internal Medicine (Cardiovascular Disease)

415 ROUTE 24, SUITE E
CHESTER, NJ 07930

Morris County (908) 879-1500

LAWRENCE C. ANTONUCCI MD LLC

Internal Medicine (Cardiovascular Disease)

415 ROUTE 24, SU E
CHESTER, NJ 07930

Morris County (908) 879-1500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Clifford Sebastian's NPI number?

The NPI number for Clifford Sebastian is 1164409538. It was assigned to this individual provider in the NPPES registry on December 28, 2005.

Where is Clifford Sebastian located?

Clifford Sebastian practices at 415 Route 24 Suite E, Chester, NJ 07930. The listed phone number is (908) 879-1500.

What is Clifford Sebastian's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Clifford Sebastian enrolled in Medicare?

Yes. Clifford Sebastian is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Clifford Sebastian affiliated with any hospitals?

According to CMS data, Clifford Sebastian is affiliated with Hunterdon Medical Center, Morristown Medical Center, Saint Clare's Hospital/ Denville Campus, Hackettstown Medical Center and St Luke's Hospital Bethlehem.

When was this NPI record last updated?

The NPPES record for Clifford Sebastian was last updated on March 10, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.