Michelle Allison Clark, F.N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

340960 Issued in NY

Practice address

413 Glenbrook Rd
9
Stamford, CT 06906-2126

Phone

(973) 518-1601

NPI assigned

Oct 16, 2016

Sex

Female

Sole proprietor

Yes

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 NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Memorial Solid Tumor GroupGroup PAC ID 4082503354, 233 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital for Cancer and Allied Diseases Hospital, New York, NY, CCN 330154

Merit-based Incentive Payment System (MIPS)

Final score

75.5 of 100Reported as group

Quality

60.62

Improvement activities

40

Cost

73.87

Merit-based Incentive Payment System (MIPS)

Final score

77.91 of 100Reported as group

Quality

78.66

Improvement activities

40

Cost

48.83

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: mclark21692@mskcc.direct-ci.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.

• Memorial Solid Tumor Group

  • Internal Medicine Physician
  • New York, NY
  • NPI 1699746172
  Medicare reassignment Care Compare group NPD
• Memorial Developmental Chemo Group

  • Medical Oncology Physician
  • New York, NY
  • NPI 1912978487
  Medicare reassignment NPD
• Memorial Medical Consultation Group

  • Internal Medicine Physician
  • New York, NY
  • NPI 1053382523
  Medicare reassignment NPD
• MSK Harrison

  • Medical Oncology Physician
  • West Harrison, NY
  • NPI 1174923593
  Medicare reassignment NPD

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

• Memorial Hospital for Cancer & Allied Diseases

  • General Acute Care Hospital
  • Basking Ridge, NJ
  • NPI 1659385474
  Care Compare affiliation
• Memorial Hospital for Cancer and Allied Diseases

  • General Acute Care Hospital
  • New York, NY
  • NPI 1700887411
  Care Compare affiliation
• Memorial Sloan Kettering Bergen

  • General Acute Care Hospital
  • Montvale, NJ
  • NPI 1841650330
  Care Compare affiliation
• Memorial Sloan Kettering Monmouth

  • General Acute Care Hospital
  • Middletown, NJ
  • NPI 1528428521
  Care Compare affiliation
• Ralph Lauren Center for Cancer Care and Prevention

  • Special Hospital
  • New York, NY
  • NPI 1770046351
  Care Compare affiliation

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

{
    "created_epoch": "1476576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476576000000",
    "number": "1215488168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 GLENBROOK RD",
            "address_2": "9",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069062126",
            "telephone_number": "973-518-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 GLENBROOK RD",
            "address_2": "9",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069062126",
            "telephone_number": "973-518-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MICHELLE",
        "middle_name": "ALLISON",
        "name_prefix": "Mrs.",
        "credential": "F.N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-16",
        "last_updated": "2016-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "340960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig C. Clabaugh, DMD
• Clarity Mental Health, Inc
• Bennett William Clark, M.D.
• Chelsea Marie Clark, PA-C
• Justin Liam Clark, DPT
• Sarah Clark, MS CGC
• Debbie A. Clarke, PA
• Hannah Clarke, NP
• Monique Teresa Class, APRN
• Clear Smile Dental Studio PLLC

• Family Nurse Practitioner in Stamford, CT
• Providers in Stamford, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2016; 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.