NPIMap

Individual provider Active NPI

Robert A Clarke, MD

  • Internal Medicine Physician
  • East Orange, NJ
National Provider Identifier
1114934007
Registry record updated Jan 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA08005400 Issued in NJ
Practice address
108 South Munn Ave
East Orange, NJ 07018
Phone
(973) 674-8100
Fax
(973) 674-8400
NPI assigned
Aug 2, 2006
Last updated
Jan 8, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA08005400 NJ Primary

Addresses

Primary practice location

108 South Munn Ave
East Orange, NJ 07018

Mailing address

108 South Munn Ave
East Orange, NJ 07018
Phone (973) 674-8100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060426000423 NJ Practitioner - Internal Medicine 9739199480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

108 S Munn Ave
East Orange, NJ 07018-3402
Phone (973) 674-8100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
East Orange Medical Practice Internal Medicine CurrentSince Jan 1, 2006 Accepting new patients
Eoh Acquisition Group, LLC Past Accepting new patients
Complete Care at East Orange LLC Past Accepting new patients
Newark Beth Israel Medical Center Inc Past Accepting new patients
University Hospital Past Accepting new patients
Prime Healthcare Services - St Michaels LLC Past Accepting new patients
White House Healthcare Center LLC Past Accepting new patients
White House Healthcare and Rehabilitation Center Inc. Past Accepting new patients

Locations

108 S Munn Ave
East Orange, NJ 07018
Phone (973) 674-8100

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Complete Care at Orange ParkEast Orange, NJ, CCN 315178 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 19, 2021
Oct 19, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

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 8

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389139200000",
    "number": "1114934007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 SOUTH MUNN AVE",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "07018",
            "telephone_number": "973-674-8100",
            "fax_number": "973-674-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 SOUTH MUNN AVE",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "07018",
            "telephone_number": "973-674-8100",
            "fax_number": "973-674-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "ROBERT",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2014-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08005400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Orange, NJ

Sources for this page

Verify at the official NPI Registry.