Chyn-Ni Hu Clark, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC4597 Issued in FL

Practice address

4340 Newberry Rd.
Suite301
Gainesville, FL 32607-2557

Phone

(352) 372-9414

Fax

(352) 271-5393

NPI assigned

Feb 7, 2011

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Medicial Associates of AbileneGroup PAC ID 7012990112, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: chynni.clark.p1@direct.abileneeye.nextgenshare.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.

• Eye Medicial Associates of Abilene

  • Ophthalmology Physician
  • Abilene, TX
  • NPI 1043325996
  Medicare reassignment Care Compare group
• Aeg Florida Professional PLLC

  • Optometrist
  • Jacksonville, FL
  • NPI 1164156246
  NPD (past)
• Abilene Eye ASC LP

  • Ambulatory Surgical Clinic/Center
  • Abilene, TX
  • NPI 1205808938
  NPD (past)

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

{
    "created_epoch": "1297036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1285930362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4340 NEWBERRY RD.",
            "address_2": "SUITE 301",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326072557",
            "telephone_number": "352-372-9414",
            "fax_number": "352-271-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4340 NEWBERRY RD.",
            "address_2": "SUITE301",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326072557",
            "telephone_number": "352-372-9414",
            "fax_number": "352-271-5393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHYN-NI",
        "middle_name": "HU",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-07",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4597",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "R208TA35",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003813900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Antanae Shariah Clark
• Arianna Clark, RBT
• Arthur E. Clark, D.M.D.
• Carolyn R Clark, O.D.
• Chelsea Diamond Clark
• Connetra Lashan Clark
• Danielle Clark, LMHC
• Jaime Clark
• Jammi Leigh Clark
• Kevin Alan Clark

• Optometrist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; 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.