Samuel T Clark II, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

27446 Issued in AZ

Practice address

4400 N 32ND St
Ste 110
Phoenix, AZ 85018-3953

Phone

(602) 956-9595

Fax

(602) 956-3232

NPI assigned

Aug 25, 2005

Last updated

Apr 1, 2011By 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

Medicare fee-for-service enrollment

Enrolled in AZ

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

University of Louisville School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sunny View Medical Center PLLCGroup PAC ID 7810952686, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Honor Health John C. Lincoln Medical Center Hospital, Phoenix, AZ, CCN 030014
• St Josephs Hospital and Medical Center Hospital, Phoenix, AZ, CCN 030024

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Sunny View Medical Center PLLC

  • Chiropractor
  • Phoenix, AZ
  • NPI 1992873350

  Family Medicine

  Medicare reassignment Care Compare group NPD Authorized official
• Sunny View Medical Center, PLLC

  • Chiropractor
  • Phoenix, AZ
  • NPI 1053684498
  NPD Authorized official
• Dignity Health

  dba Mercy Medical Center Redding

  • General Acute Care Hospital
  • Redding, CA
  • NPI 1477671535
  NPD (past)

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

• Dignity Health

  dba St. Josephs Hospital and Medical Center Emergency Dept-Litchfield Park

  • Emergency Care Clinic/Center
  • Litchfield Park, AZ
  • NPI 1265065445

  Hospital

  Care Compare affiliation
• Dignity Health

  dba St. Josephs Hospital and Medical Center Emergency Dept-Glendale

  • Emergency Care Clinic/Center
  • Glendale, AZ
  • NPI 1609408665

  Hospital

  Care Compare affiliation
• Dignity Health

  dba St. Joseph's Hospital and Medical Center

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1982733655
  Care Compare affiliation
• Dignity Health

  dba St. Joseph's Westgate Medical Center

  • General Acute Care Hospital
  • Glendale, AZ
  • NPI 1992131734
  Care Compare affiliation
• Honorhealth

  dba HonorHealth John C. Lincoln Medical Center

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1770690695
  Care Compare affiliation

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301616000000",
    "number": "1073506036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 N 32ND ST",
            "address_2": "STE 110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850183953",
            "telephone_number": "602-956-9595",
            "fax_number": "602-956-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 N 32ND ST",
            "address_2": "STE 110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850183953",
            "telephone_number": "602-956-9595",
            "fax_number": "602-956-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SAMUEL",
        "middle_name": "T",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2011-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "27446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melvin Jerome Clark, M.D.
• Nicholas McKinley Clark, PA-C
• Paige N Clark, MC
• Philip Clark, LDO
• Randolph A Clark, M.D.
• Samuela Clark, LVN
• Seth Clark, DPM
• Shamara Lashai Clark
• Shannon Nichole Clark, AU.D.
• Shauna Clark, MSPT

• Family Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2011; 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.