John F.J. Clark III

Primary specialty

SpecialistTaxonomy code 174400000X

License

160560-1 Issued in NY

Practice address

255 Central Park W
Suite # 3
New York, NY 10024-4101

Phone

(212) 769-0666

Fax

(212) 799-6193

NPI assigned

Jan 31, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. John Francis, James Clark III Professional name

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Obstetrics/Gynecology

Education

Meharry Medical College School of Medicine, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bethpage Medical PLLCGroup PAC ID 3375692387, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: jclark674070@nychhc.direct-ci.com
• Direct secure messaging: jclark@rmhclinics.medentdirect.com

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.

• Bethpage Medical, PLLC

  • Obstetrics & Gynecology Physician
  • Garden City, NY
  • NPI 1205074739
  Medicare reassignment Care Compare group NPD
• Harlem Medical Associates PC

  • General Practice Physician
  • New York, NY
  • NPI 1487957692
  Medicare reassignment NPD
• Westchester Medical Center Advanced Physician Services, PC

  • Surgery Physician
  • Valhalla, NY
  • NPI 1912131392
  Medicare reassignment NPD
• William F Ryan Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • New York, NY
  • NPI 1851328199
  Medicare reassignment
• Westchester Medical Center Advanced Physician Services PC

  • Anesthesiology Physician
  • Valhalla, NY
  • NPI 1740687458
  NPD
• Ryan-Chelsea Clinton Community Health Center

  • Federally Qualified Health Center (FQHC)
  • New York, NY
  • NPI 1215978960
  NPD (past)

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194862730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 CENTRAL PARK W",
            "address_2": "SUITE # 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100244101",
            "telephone_number": "212-769-0666",
            "fax_number": "212-799-6193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 CENTRAL PARK W",
            "address_2": "SUITE # 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100244101",
            "telephone_number": "212-769-0666",
            "fax_number": "212-799-6193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JOHN",
        "middle_name": "F.J.",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "160560-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00963231",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "CLARK",
            "middle_name": "FRANCIS, JAMES",
            "prefix": "DR.",
            "suffix": "III",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jamilah Ellena Clark, LMSW
• Janet Rebecca Clark, OTR/L
• Jeanann Clark, PHYSICIAN ASSISTANT
• Jenifer Clark, PHD
• Joanne N.S. Clark, LCSW
• Joy Arlene Clark, M.D.
• Katherine Clark, N.P.
• Katherine E Clark
• Kristen Clark, MD
• Madison R Clark, NP

• Specialist in New York, NY
• Providers in New York, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.