CLINTON EHIDOM MD
NPI 1487398814
Student in an Organized Health Care Education/Training Program in New York, NY

Active since April 22, 2022PECOS EnrolledAccepts Medicare Assignment
525 E 68TH ST, NEW YORK, NY 10065(212) 746-6515 Get Directions Write a Review

NPPES record last updated: April 22, 2022. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Clinton Ehidom Md NPPES

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

CLINTON EHIDOM MD (NPI 1487398814) is an individual student in an organized health care education/training program in New York, New York and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1487398814
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameCLINTON EHIDOMCredential: MD
Location Address525 E 68TH STNew York, NY 10065-4870
Mailing Address27 Amherst StEast Williston, NY 11596-1836 · (347) 854-2352
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateApril 22, 2022
NPPES CertifiedApril 22, 2022
NPI 1487398814 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
525 E 68TH ST, New York, NY 10065

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

Clinton Ehidom 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 ID7618440264
PECOS Enrollment IDI20260624004322
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.

Other Providers at the Same Location NPPES 20

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

Surgery
525 E 68TH ST
NEW YORK, NY 10065
Nurse Practitioner (Adult Health)
525 E 68TH ST
NEW YORK, NY 10065
Hospitalist
525 E 68TH ST
NEW YORK, NY 10065
Physical Medicine & Rehabilitation (Sports Medicine)
525 E 68TH ST
NEW YORK, NY 10065
Specialist
525 E 68TH ST
NEW YORK, NY 10065
Physician Assistant
525 E 68TH ST
NEW YORK, NY 10065
Psychiatry & Neurology (Psychiatry)
525 E 68TH ST, MAIL SLOT 140
NEW YORK, NY 10065
Student in an Organized Health Care Education/Training Program
525 E 68TH ST
NEW YORK, NY 10065

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 Clinton Ehidom's NPI number?

The NPI number for Clinton Ehidom is 1487398814. It was assigned to this individual provider in the NPPES registry on April 22, 2022.

Where is Clinton Ehidom located?

Clinton Ehidom practices at 525 E 68th St, New York, NY 10065. The listed phone number is (212) 746-6515.

What is Clinton Ehidom's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Clinton Ehidom enrolled in Medicare?

Yes. Clinton Ehidom 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.

When was this NPI record last updated?

The NPPES record for Clinton Ehidom was last updated on April 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.