Michael E Clark, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

013687 Issued in ME

Practice address

4 Sheridan Drive
Fairfield, ME 04937

Phone

(207) 861-5000

Fax

(207) 861-5001

NPI assigned

Feb 28, 2006

Last updated

Oct 16, 2012By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Enrolled in ME

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

Wake Forest University School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mainegeneral Medical CenterGroup PAC ID 1254245715, 554 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Maine General Medical Center Hospital, Augusta, ME, CCN 200039
• Sanfield Rehab & Living Center Nursing home, Hartland, ME, CCN 205174

Merit-based Incentive Payment System (MIPS)

Final score

86.22 of 100Reported as group

Quality

75.39

Promoting interoperability

84

Improvement activities

40

Cost

75.32

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michaelclark@mgh.allscriptsdirect.net

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

• Mainegeneral Medical Center

  • General Acute Care Hospital
  • Augusta, ME
  • NPI 1669423380
  Medicare reassignment Care Compare group NPD
• Mainegeneral Medical Center

  dba MaineGeneral Pharmacy

  • Community/Retail Pharmacy
  • Waterville, ME
  • NPI 1477344976
  NPD
• North Country Associates, Inc

  dba Sanfield Living Center

  • Skilled Nursing Facility
  • Hartland, ME
  • NPI 1326108002
  NPD (past)
• North Country Associates, Inc

  dba Klearview Manor

  • Intellectual Disabilities Intermediate Care Facility
  • Fairfield, ME
  • NPI 1821158981
  NPD (past)

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

• North Country Associates, Inc

  dba Sanfield Living Center

  • Skilled Nursing Facility
  • Hartland, ME
  • NPI 1326108002

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1053387936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SHERIDAN RD",
            "city": "FAIRFIELD",
            "state": "ME",
            "postal_code": "049373314",
            "telephone_number": "207-861-5000",
            "fax_number": "207-861-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SHERIDAN DRIVE",
            "city": "FAIRFIELD",
            "state": "ME",
            "postal_code": "04937",
            "telephone_number": "207-861-5000",
            "fax_number": "207-861-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "013687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053387936",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272100099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaeti Butterfield, RN
• Beth Ann Calvert, LSWC
• Caring Hands
• Caring Hands (Caring Hands Adult Day Respite)
• Caring Hands
• Robert Colby, LCSW
• Christine Custer, PTA
• Hannah Dangler, LMSW-CC
• John Delgiudice, P.T.
• Dialysis Clinic Inc

• Family Medicine Physician in Fairfield, ME
• Providers in Fairfield, ME by specialty
• Family Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; 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.