NPIMap

Individual provider Active NPI

Philip Willie Bankole Clarkson, M.D

  • Internal Medicine Physician
  • Neptune, NJ
National Provider Identifier
1073923835
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0101020 Issued in MD
Practice address
1945 State Route 33
Neptune, NJ 07753-4859
Phone
(732) 776-4483
Fax
(732) 776-4798
NPI assigned
May 2, 2014
Last updated
Sep 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 327639 NY
Internal Medicine Physician 207R00000X 0101274669 VA
Internal Medicine Physician 207R00000X D0101020 MD Primary
Hospitalist Physician 208M00000X 0101274669 VA
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X A147483 CA
Hospitalist Physician 208M00000X 01089212A IN
Hospitalist Physician 208M00000X A147483 CA

Addresses

Primary practice location

1945 State Route 33
Neptune, NJ 07753-4859

Mailing address

1945 State Route 33
Neptune, NJ 07753-4859
Phone (732) 776-4483

Other practice location 1

111 Hospital Dr
Utica, NY 13502-2517
Phone (315) 917-9966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NY, DC3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20220706002512 VA Practitioner - Hospitalist 6507139359 Reassigns benefits to 1 organization
I20240614002376 NY Practitioner - Hospitalist 6507139359 Reassigns benefits to 1 organization
I20250917001125 DC Practitioner - Hospitalist 6507139359 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Galen Inpatient Physicians PCGroup PAC ID 3678464633, 1,045 clinicians
Vituity-Virginia Hospitalists PCGroup PAC ID 6507245131, 109 clinicians

Practice addresses (Care Compare)

111 Hospital Dr
Utica, NY 13502-2517
Phone (315) 917-9966

19801 Observation Dr
Germantown, MD 20876-4070
Phone (301) 557-5928

5801 Bremo Rd
Richmond, VA 23226-1907
Phone (804) 285-2011

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A147483CAMDInternal Medicine Physician
D0101020MDMDInternal Medicine Physician
01089212AINMDHospitalist Physician
327639NYMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Galen Inpatient Physicians PC Hospitalist CurrentSince Sep 14, 2025 Accepting new patients
New York Medical Physician Associates PC Hospitalist CurrentSince Jun 17, 2024 Accepting new patients
New York Medical Physician Associates PC Internal Medicine Current Accepting new patients
Galen Inpatient Physicians PC Hospitalist Current Accepting new patients
Vituity-Virginia Hospitalists PC Hospitalist CurrentSince Jun 1, 2022 Accepting new patients
New York Medical Physician Associates PC Hospitalist CurrentSince Jun 17, 2024 Accepting new patients
California Emergency Physicians Medical Group, a Professional Corp Past Accepting new patients
Holy Cross Health, Inc. Past Accepting new patients
Sports Medicine Grant, Inc Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

19801 Observation Dr
Germantown, MD 20876
Phone (301) 557-5928

111 Hospital Dr
Utica, NY 13502
Phone (315) 801-8534

5801 Bremo Rd
Richmond, VA 23226
Phone (804) 281-8220

Organizations & group practices 9

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.

Hospital & facility affiliations 12

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

NPI Registry JSON

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

{
    "created_epoch": "1398988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1073923835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 STATE ROUTE 33",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534859",
            "telephone_number": "732-776-4483",
            "fax_number": "732-776-4798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 STATE ROUTE 33",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534859",
            "telephone_number": "732-776-4483",
            "fax_number": "732-776-4798"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Utica",
            "state": "NY",
            "postal_code": "135022517",
            "country_code": "US",
            "telephone_number": "315-917-9966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARKSON",
        "first_name": "PHILIP",
        "middle_name": "WILLIE BANKOLE",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-02",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "327639",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101274669",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0101020",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101274669",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A147483",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01089212A",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A147483",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neptune, NJ

Sources for this page

Verify at the official NPI Registry.