Samuel Damain Pepeto Clarke, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME162657 Issued in FL

Practice address

300 Clyde Morris Blvd Ste a
Ormond Beach, FL 32174-5909

Phone

(386) 317-8620

Fax

(386) 317-8625

NPI assigned

Aug 19, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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 1

Specialty

Family Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Health Care Plan IncGroup PAC ID 9436201233, 97 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Florida Health Care Plan, Inc

  • Preferred Provider Organization
  • Daytona Beach, FL
  • NPI 1558302042
  Medicare reassignment Care Compare group NPD
• Agapemd, LLC

  • Health Service Clinic/Center
  • Tavernier, FL
  • NPI 1639561186
  Medicare reassignment NPD
• Florida Health Care Plan, Inc

  • Ambulatory Surgical Clinic/Center
  • Orange City, FL
  • NPI 1659759827
  NPD

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1013529304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CLYDE MORRIS BLVD STE A",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745909",
            "telephone_number": "386-317-8620",
            "fax_number": "386-317-8625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CLYDE MORRIS BLVD STE A",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745909",
            "telephone_number": "386-317-8620",
            "fax_number": "386-317-8625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "SAMUEL",
        "middle_name": "DAMAIN PEPETO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-19",
        "last_updated": "2025-01-06",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME162657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Lee Christlieb, ARNP
• Dewey A Christmas Jr., MD
• John England Christopher III, DC
• Maria Cilenti
• Perrin C Clark, M.D.
• Cathlyn Ann Clay
• Clear Solutions Hearing Center
• Toya Latrice Clements
• Kimberly Ann Clermont, FNP
• Ashley Renee Cline

• Family Medicine Physician in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.