NPIMap

Individual provider Active NPI

Wesley Hurst Clark, MD, MPH

  • Anesthesiology Physician
  • Brooklyn, NY
National Provider Identifier
1225356355
Registry record updated Jan 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
042.0012930 Issued in VT
Practice address
457 State St Apt 3B
Brooklyn, NY 11217-1864
Phone
(718) 986-8391
NPI assigned
May 13, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2017

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 042.0012930 VT Primary
Anesthesiology Physician 207L00000X 272912 NY
Anesthesiology Physician 207L00000X 25MA09563000 NJ
Anesthesiology Physician 207L00000X 17811 NH

Addresses

Primary practice location

457 State St Apt 3B
Brooklyn, NY 11217-1864

Mailing address

457 State St Apt 3B
Brooklyn, NY 11217-1864
Phone (718) 986-8391

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140825002666 VT Practitioner - Anesthesiology 9133347636 Reassigns benefits to 4 organizations
I20160114000517 NY Practitioner - Anesthesiology 9133347636 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Porter Hospital IncGroup PAC ID 1850365180, shared by 5 NPIs, 116 clinicians

Practice addresses (Care Compare)

115 Porter Dr
Middlebury, VT 05753-8423
Phone (802) 382-3443

Hospital & facility affiliations

  • Porter Hospital Inc Hospital, Middlebury, VT, CCN 471307

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09563000NJMDAnesthesiology Physician
272912NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Porter Hospital Inc Anesthesiology CurrentSince May 1, 2020 Accepting new patients
York Anesthesiologists PLLC Anesthesiology CurrentSince May 1, 2017 Accepting new patients
Porter Hospital, Inc CurrentSince May 1, 2020 Accepting new patients
Porter Hospital Inc Current Accepting new patients
Premier Anesthesia of New York, P.C. Anesthesiology CurrentSince Dec 3, 2015 Accepting new patients

Locations

529 Central Ave
Dunkirk, NY 14048
Phone (716) 338-9797

2233 State Route 86
Saranac Lake, NY 12983
Phone (518) 891-4141

61 Court Dr
Brandon, VT 05733
Phone (802) 247-3755

37 Porter Dr
Middlebury, VT 05753
Phone (802) 388-4705

104 Porter Dr
Middlebury, VT 05753
Phone (802) 388-5682

115 Porter Dr
Middlebury, VT 05753
Phone (802) 388-4701

82 Catamount Park
Middlebury, VT 05753
Phone (802) 388-7185

Networks

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

Interoperability endpoints

  • Direct secure messaging: wclark129783@direct.uvmhealth.org

Organizations & group practices 6

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1273708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1225356355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 STATE ST APT 3B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112171864",
            "telephone_number": "718-986-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "457 STATE ST APT 3B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112171864",
            "telephone_number": "718-986-8391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "WESLEY",
        "middle_name": "HURST",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-13",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VT",
            "license": "042.0012930",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "272912",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA09563000",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NH",
            "license": "17811",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.