COMMUNITY CLINIC OF JEFFERSON COUNTY
NPI 1538455696
Community/Behavioral Health in Watertown, NY
About Community Clinic Of Jefferson County NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
COMMUNITY CLINIC OF JEFFERSON COUNTY (NPI 1538455696) is a healthcare organization registered as a community/behavioral health in Watertown, New York and active in the NPI registry since June 2011. The organization maintains 3 additional practice locations and lists Michelle L Monnat, President And Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Secondary Practice Locations 3
Other Identifiers 2
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Community Clinic Of Jefferson County is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
10Medicare enrollment records show 10 clinicians reassign Medicare billing to Community Clinic Of Jefferson County, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.
Clinicians by Medicare Specialty 3
Clinicians, nearest first (10)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Children's Home Of Jefferson County's NPI number?
The NPI number for Children's Home Of Jefferson County is 1538455696. It was assigned to this organization in the NPPES registry on June 27, 2011. The provider is also known as Community Clinic Of Jefferson County.
Where is Children's Home Of Jefferson County located?
Children's Home Of Jefferson County is located at 211 Jb Wise Pl, Watertown, NY 13601. The listed phone number is (315) 782-7445.
What is Children's Home Of Jefferson County's specialty?
The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.
Is Children's Home Of Jefferson County enrolled in Medicare?
Yes. Children's Home Of Jefferson County is registered in the Medicare PECOS enrollment system.
When is Children's Home Of Jefferson County's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New York, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Children's Home Of Jefferson County?
According to the CMS Revalidation Reassignment List (October 2026 release), 10 clinicians in 3 Medicare specialties reassign their Medicare billing to Children's Home Of Jefferson County. A 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 the clinician's services. The largest specialties are Nurse Practitioner (6), Psychiatry (3) and Clinical Social Worker (1). Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Children's Home Of Jefferson County was last updated on July 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Community Clinic Of Jefferson County · NPI 1538455696
Community/Behavioral Health organization in Watertown, New York. Organization record, active in the CMS NPPES registry since June 27, 2011.
## Identity
- **NPI:** 1538455696 (Entity type: Organization)
- **Enumerated:** June 27, 2011
- **Primary specialty:** Community/Behavioral Health · taxonomy 251S00000X
- **Legal business name:** Children's Home Of Jefferson County
- **Organization subpart:** No
- **Authorized official:** Michelle Monnat, PRESIDENT AND CEO
## Practice location
- **Address:** 211 JB WISE PL, Watertown, NY 13601-2507
- **Phone:** (315) 782-7445 · **Fax:** (315) 779-1184
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, New York, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 10 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (6), Psychiatry (3), Clinical Social Worker (1); 4 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 8, 2024
- **Other identifiers:** Other 9298014A (NY); Medicaid 3372621 (NY)
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Source: [NPI Profile](https://npiprofile.com/npi/1538455696) · Data from the CMS NPPES public registry.