Bryan Bret Clark

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

MD1811394 Issued in OR

Practice address

842 E Main St
Medford, OR 97504-7134

Phone

(801) 870-0588

NPI assigned

Apr 10, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, OR2 enrollments

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 2

Specialty

Anesthesiology

Education

University of Vermont College of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia Associates of Medford PCGroup PAC ID 5597750323, 47 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018
• Providence Medford Medical Center Hospital, Medford, OR, CCN 380075

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Anesthesia Associates of Medford PC

  • Anesthesiology Physician
  • Medford, OR
  • NPI 1073543963
  Medicare reassignment Care Compare group NPD
• Asante

  dba Asante Rogue Regional Medical Center

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  Medicare reassignment NPD
• KND Development 59 LLC

  • Hospitalist Physician
  • Santa Ana, CA
  • NPI 1740519081
  Medicare reassignment NPD
• Asante

  dba Heimann Cancer Center

  • Specialty Pharmacy
  • Medford, OR
  • NPI 1699426684
  NPD
• KND Development 59, LLC

  • Hospitalist Physician
  • San Leandro, CA
  • NPI 1235468562
  NPD
• KND Development 59, LLC

  dba Specialty Hospitals Broken Arrow

  • Hospitalist Physician
  • Broken Arrow, OK
  • NPI 1922950823
  NPD
• Active Health Chiropractic, PC

  • Chiropractor
  • Central Point, OR
  • NPI 1780989889
  NPD (past)

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

• Asante

  dba Asante Rogue Regional Medical Center

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  Care Compare affiliation
• Providence Health & Services - Oregon

  dba Providence Medford Medical Center

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1689755670
  Care Compare affiliation

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

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1144663030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 E MAIN ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047134",
            "telephone_number": "801-870-0588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "842 E MAIN ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047134",
            "telephone_number": "801-870-0588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "BRYAN",
        "middle_name": "BRET",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-10",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD1811394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Claassen, DDS
• Jonathan Michael Claassen, MD
• Jacqueline Rose Clair-Horn, O.D.
• Leslie Elizabeth Claridge Town
• Clarity Behavioral Medicine LLC
• Carolyn Clark, QMHA, PSS, CRM, CGAC
• Diane Clark, R.PH.
• Kim Clark, CADCI, A.A.
• Madeline Dorothy Clark
• Tiffany Dawn Clark, LMT

• Anesthesiology Physician in Medford, OR
• Providers in Medford, OR by specialty
• Anesthesiology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; 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.