Clark Van Den Berghe, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

256393 Issued in MA

Practice address

269 Union St
Lynn, MA 01901-1314

Phone

(781) 596-2502

Fax

(781) 596-3966

NPI assigned

Jul 11, 2013

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 MA

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

Northwestern University Feinberg Medical School, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lynn Community Health, Inc.Group PAC ID 0042217507, 95 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Shore Medical Center - Hospital, Salem, MA, CCN 220035

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cvandenberghe212795@direct.ochin.org

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.

• Lynn Community Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Lynn, MA
  • NPI 1013997691
  Medicare reassignment Care Compare group NPD
• North Shore Medical Center, Inc.

  • General Acute Care Hospital
  • Salem, MA
  • NPI 1730121633
  NPD (past)

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

• North Shore Medical Center, Inc.

  • General Acute Care Hospital
  • Salem, MA
  • NPI 1730121633
  Care Compare affiliation

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

{
    "created_epoch": "1373500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1053752675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 UNION ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011314",
            "telephone_number": "781-581-3900",
            "fax_number": "781-598-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 UNION ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011314",
            "telephone_number": "781-596-2502",
            "fax_number": "781-596-3966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DEN BERGHE",
        "first_name": "CLARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "256393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juana L Vainer, M.D.
• Richard Cornell Valentine Jr.
• Darlene Altagracia Valenzuela
• Valle Associates, Inc
• Stephen K. Valle, SC.D.
• Anne-Terese Van Der Burg
• Jaime Victor Vara, B.A
• Johanna Natividad Vargas, B.A.
• Elena Y Vasquez
• Ilya Vasserman, DMD

• Family Medicine Physician in Lynn, MA
• Providers in Lynn, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.