CLINTON EHIDOM MD
NPI 1487398814
Student in an Organized Health Care Education/Training Program in New York, NY
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
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignment
Medicare enrollment records show Clinton Ehidom reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Atlanta, GA 30328
- Reassigned Medicare billing, Georgia enrollment
- 6 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
NEW YORK, NY 10065
NEW YORK, NY 10065
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.
Which organization bills Medicare for Clinton Ehidom's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Clinton Ehidom reassigns Medicare benefits to Atlanta Neurology (Atlanta, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Clinton Ehidom's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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.
# Clinton Ehidom, MD · NPI 1487398814
Student in an Organized Health Care Education/Training Program provider in New York, New York. Individual provider, active in the CMS NPPES registry since April 22, 2022.
## Identity
- **NPI:** 1487398814 (Entity type: Individual)
- **Enumerated:** April 22, 2022
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 525 E 68TH ST, New York, NY 10065-4870
- **Phone:** (212) 746-6515
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Atlanta Neurology (NPI 1982823506, Atlanta, GA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** April 22, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1487398814) · Data from the CMS NPPES public registry.