Individual provider Active NPI

Alexander Jay Clark, MD

  • Emergency Medicine Physician
  • Cary, NC
National Provider Identifier
1194385872
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2022-01612 Issued in NC
Practice address
210 Towne Village Dr
Cary, NC 27513-8910
Phone
(919) 859-3373
NPI assigned
Jun 16, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 2022-01612 NC Primary

Addresses

Primary practice location

210 Towne Village Dr
Cary, NC 27513-8910

Mailing address

210 Towne Village Dr
Cary, NC 27513-8910
Phone (919) 859-3373

Other practice location 1

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 667-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220804002166 NC Practitioner - Emergency Medicine 3678955879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Emergency Physicians PAGroup PAC ID 9931002078, 269 clinicians

Practice addresses (Care Compare)

1010 College St
Oxford, NC 27565-2507
Phone (919) 690-3000

Hospital & facility affiliations

  • Unc Health Nash Hospital, Rocky Mount, NC, CCN 340147

Merit-based Incentive Payment System (MIPS)

Final score
82.58 of 100Reported as group
Quality
75.66
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2022-01612NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Emergency Physicians PA Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients
Wake Emergency Physicians PA Emergency Medicine Current Accepting new patients
Wake Emergency Physicians PA Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients
Wake Emergency Physicians PA Emergency Medicine PastSince Jul 24, 2022 Accepting new patients

Locations

210 Towne Village Dr
Cary, NC 27513
Phone (919) 348-4483

1010 College St
Oxford, NC 27565
Phone (919) 623-5115

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

Interoperability endpoints

  • Direct secure messaging: aclark857930@direct.unc.nchie.net

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.

Hospital & facility affiliations 1

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": "1560643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1194385872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 TOWNE VILLAGE DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138910",
            "telephone_number": "919-859-3373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 TOWNE VILLAGE DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138910",
            "telephone_number": "919-859-3373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 Brookline Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "022155400",
            "country_code": "US",
            "telephone_number": "617-667-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ALEXANDER",
        "middle_name": "JAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-16",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2022-01612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.