Individual provider Active NPI

Robert Mel Clark, MD

  • Interventional Cardiology Physician
  • Oklahoma City, OK
National Provider Identifier
1174528525
Registry record updated Apr 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
12336 Issued in OK
Practice address
3433 NW 56TH St Ste 400
Oklahoma City, OK 73112-4430
Phone
(405) 947-3341
NPI assigned
Jun 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 12336 OK
Interventional Cardiology Physician 207RI0011X 12336 OK Primary

Addresses

Primary practice location

3433 NW 56TH St Ste 400
Oklahoma City, OK 73112-4430

Mailing address

3433 NW 56TH St
Ste 400
Oklahoma City, OK 73112-4430
Phone (405) 947-3341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.7 of 100Reported as group
Quality
73.46
Promoting interoperability
100
Improvement activities
40
Cost
69.29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12336OKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Hospital Past Accepting new patients
Integris Canadian Valley Hospital Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Integris Baptist Associates Cardiovascular Disease Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1174528525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 NW 56TH ST",
            "address_2": "STE 400",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124430",
            "telephone_number": "405-947-3341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3433 NW 56TH ST STE 400",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124430",
            "telephone_number": "405-947-3341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ROBERT",
        "middle_name": "MEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OK",
            "license": "12336",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OK",
            "license": "12336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.