Active NPI
Eugene P Clerkin, MD
- Endocrinology, Diabetes & Metabolism Physician
- Burlington, MA
National Provider Identifier
1194823104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- License
- 27427
- Practice address
- 41 Mall Rd
Lahey Clinic
Burlington, MA 01805-0001 - Phone
- (781) 744-8000
- Fax
- (781) 744-5348
- NPI assigned
- Sep 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 27427 | MA | Primary |
| Internal Medicine Physician | 207R00000X | 27427 | MA |
Addresses
Primary practice location
41 Mall Rd
Lahey Clinic
Burlington, MA 01805-0001
Mailing address
41 Mall Rd
Lahey Clinic
Burlington, MA 01805-0001
Phone (781) 744-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6167039 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27427 | MA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287619200000",
"number": "1194823104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 MALL RD",
"address_2": "LAHEY CLINIC",
"city": "BURLINGTON",
"state": "MA",
"postal_code": "018050001",
"telephone_number": "781-744-8000",
"fax_number": "781-744-5348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41 MALL RD",
"address_2": "LAHEY CLINIC",
"city": "BURLINGTON",
"state": "MA",
"postal_code": "018050001",
"telephone_number": "781-744-8000",
"fax_number": "781-744-5348"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLERKIN",
"first_name": "EUGENE",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-21",
"last_updated": "2010-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": "MA",
"license": "27427",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "27427",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6167039",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Burlington, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.