Edward C Clark, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

MD055901L Issued in PA

Practice address

311 W 24TH St
Suite 402
Erie, PA 16502-2665

Phone

(814) 453-6687

Fax

(814) 456-4676

NPI assigned

Jul 22, 2005

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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in PA

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

NephrologyAlso: Internal Medicine

Education

Hahnemann University College of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Associates in Nephrology PCGroup PAC ID 2062409337, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• DaVita Dialysis Center of Erie Dialysis facility, Erie, PA, CCN 392528
• DaVita Warren Dialysis Dialysis facility, Warren, PA, CCN 392666
• DaVita Millcreek Dialysis Dialysis facility, Erie, PA, CCN 392822

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DAJBAA
• Direct secure messaging: edward.clark@rkdc.eclinicaldirectplus.com
• FHIR API: https://fhir4.healow.com/fhir/r4/FGEEBA/Endpoint/FGEEBA

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.

• Associates in Nephrology PC

  • Nephrology Physician
  • Erie, PA
  • NPI 1568419448
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Warren, PA
  • NPI 1245419126

  Dialysis facility

  Care Compare affiliation Name & address match
• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Erie, PA
  • NPI 1730599119

  Dialysis facility

  Care Compare affiliation Name & address match
• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Erie, PA
  • NPI 1851570733

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258070400000",
    "number": "1013917814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W 24TH ST",
            "address_2": "SUITE 402",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022665",
            "telephone_number": "814-453-6687",
            "fax_number": "814-456-4676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W 24TH ST",
            "address_2": "SUITE 402",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022665",
            "telephone_number": "814-453-6687",
            "fax_number": "814-456-4676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "EDWARD",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2009-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MD055901L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK PA BS",
            "identifier": "776463",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015345390001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC",
            "identifier": "208292",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PALMETTO",
            "identifier": "390004949",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corissa Claar, LSW
• Stephanie E Clapp, PHARM.D.
• Caitlin S Clark, DO
• Christopher C Clark, DO
• Danielle Y Clark, NCP
• Elaina Marie Clark, CRNP
• Eric Clark
• Garrett Clark, D.O.
• Geralynn Mary Clark
• Mindy M Clark, CNM

• Nephrology Physician in Erie, PA
• Providers in Erie, PA by specialty
• Nephrology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2009; 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.