Rebecca Ortolano Clark, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101277667 Issued in VA

Practice address

107 N Virginia Ave
Falls Church, VA 22046-3336

Phone

(703) 532-4446

NPI assigned

May 18, 2010

Last updated

Nov 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Rebecca Megan Ortolano Former name

Medicare fee-for-service enrollment

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northern Virginia Pediatrics PC

  • Pediatrics Physician
  • Falls Church, VA
  • NPI 1780888776
  NPD (past)

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

{
    "created_epoch": "1274140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1275852139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 N VIRGINIA AVE",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220463336",
            "telephone_number": "703-532-4446",
            "fax_number": "703-532-8426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N VIRGINIA AVE",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220463336",
            "telephone_number": "703-532-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "REBECCA",
        "middle_name": "ORTOLANO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-18",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101277667",
            "primary": true
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "NE",
            "license": "26754",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "ORTOLANO",
            "middle_name": "MEGAN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Iza Amargo Clark, NP
• Kellyann T Clark, NP
• Krista Clark
• Melissa Renee Clark
• Michael Robert Clark, M.D.
• Robert Clark, MD
• Sara C Clarke, FNP
• Classic ABA Services
• Gabrielle C Cleary
• Stephen C Clement, MD

• Pediatrics Physician in Falls Church, VA
• Providers in Falls Church, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.