NPIMap

Individual provider Active NPI

Robert Clark, M.D.

  • Anesthesiology Physician
  • Holland, OH
National Provider Identifier
1275659971
Registry record updated Jan 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
90123 Issued in OH
Practice address
7044 Sandy Hill Way
Holland, OH 43528-8088
Phone
(419) 491-8205
NPI assigned
Mar 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 90123 OH Primary

Addresses

Primary practice location

7044 Sandy Hill Way
Holland, OH 43528-8088

Mailing address

7044 Sandy Hill Way
Holland, OH 43528-8088
Phone (419) 491-8205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, TX2 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
I20101029000061 AK Practitioner - Anesthesiology 0446444996 Reassigns benefits to 1 organization
I20190501000481 TX Practitioner - Anesthesiology 0446444996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Nevada School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alaska Native Tribal Health ConsortiumGroup PAC ID 6709780265, 605 clinicians

Practice addresses (Care Compare)

4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone (907) 563-2662

Hospital & facility affiliations

  • Alaska Native Medical Center Hospital, Anchorage, AK, CCN 020026

Merit-based Incentive Payment System (MIPS)

Final score
90.93 of 100Reported as group
Quality
70.1
Promoting interoperability
100
Improvement activities
40
Cost
83.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
90123OHMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Denali Anesthesia, LLC Anesthesiology CurrentSince Sep 20, 2010 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Apr 9, 2019 Accepting new patients

Locations

4000 Ambassador Dr
Anchorage, AK 99508
Phone (907) 729-1900

2801 Debarr Rd
Anchorage, AK 99508
Phone (907) 264-1222

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779

Interoperability endpoints

  • Direct secure messaging: rdclark@direct.anthc.org

Organizations & group practices 2

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199836800000",
    "number": "1275659971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7044 SANDY HILL WAY",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435288088",
            "telephone_number": "419-491-8205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7044 SANDY HILL WAY",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435288088",
            "telephone_number": "419-491-8205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2008-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "90123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, OH

Sources for this page

Verify at the official NPI Registry.