Kevin Clark, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

64978 Issued in CT

Practice address

100 Grand St
New Britain, CT 06052-2016

Phone

(860) 224-5011

NPI assigned

Apr 10, 2017

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 CT, MA2 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

Pulmonary Disease

Education

University of Connecticut School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Physicians of Cape Cod HospitalGroup PAC ID 9638326671, 330 clinicians

Medical Affiliates of Cape Cod IncGroup PAC ID 3577471564, 237 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cape Cod Hospital Hospital, Hyannis, MA, CCN 220012
• Falmouth Hospital Hospital, Falmouth, MA, CCN 220135

Merit-based Incentive Payment System (MIPS)

Final score

76.23 of 100Reported as group

Quality

56.78

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

94 of 100Reported as group

Quality

83.66

Promoting interoperability

100

Improvement activities

40

Cost

66.78

Merit-based Incentive Payment System (MIPS)

Final score

84.3 of 100Reported as group

Quality

71.45

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kevin.clark@xdr.hhchealthdirect.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.

• Medical Affiliates of Cape Cod, Inc.

  • Internal Medicine Physician
  • Hyannis, MA
  • NPI 1770534927
  Medicare reassignment Care Compare group NPD
• Physicians of Cape Cod Hospital

  • Neuroradiology Physician
  • Hyannis, MA
  • NPI 1679832364

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• The Hospital of Central Connecticut at New Britain General and Bradley

  • Hospitalist Physician
  • New Britain, CT
  • NPI 1063461481

  Internal Medicine

  Medicare reassignment NPD
• Physicians of Falmouth Hospital

  • Internal Medicine Physician
  • Falmouth, MA
  • NPI 1821363698
  Medicare reassignment NPD
• Midstate Medical Center

  • General Acute Care Hospital
  • Meriden, CT
  • NPI 1154425288
  NPD
• Midstate Medical Center

  • Psychiatric Hospital Unit
  • Meriden, CT
  • NPI 1316022718
  NPD
• Midstate Medical Center

  • General Acute Care Hospital
  • Meriden, CT
  • NPI 1427007848
  NPD
• The Hospital of Central Connecticut at New Britain General and Bradley

  • Psychiatric Hospital Unit
  • New Britain, CT
  • NPI 1992867006
  NPD
• Medical Affiliates of Cape Cod, Inc.

  • Ambulatory Surgical Clinic/Center
  • Mashpee, MA
  • NPI 1306391206
  NPD
• Cape Cod Hospital Inc

  • General Acute Care Hospital
  • Hyannis, MA
  • NPI 1114984671
  NPD (past)

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

• Cape Cod Hospital Inc

  • General Acute Care Hospital
  • Hyannis, MA
  • NPI 1114984671
  Care Compare affiliation
• Falmouth Hospital Association Inc

  • General Acute Care Hospital
  • Falmouth, MA
  • NPI 1336106806
  Care Compare affiliation

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1174056899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060301921",
            "telephone_number": "860-679-4477",
            "fax_number": "860-679-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GRAND ST",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060522016",
            "telephone_number": "860-224-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KEVIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-10",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "64978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City of New Britain
• Brigit Clancy, PSY.D.
• Jeffrey Clancy
• Cristiana Clark, APRN
• Jennifer Clark, MD
• Ronald Gary Clark Jr., M.D.
• Tyeler N Clasablanca
• Aida Claudio
• Marilyn Jane Clayton, RN
• Alison Cleary-Urban, LCSW

• Internal Medicine Physician in New Britain, CT
• Providers in New Britain, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.