Maiya Yetunde Elon Clark, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

D0061964 Issued in MD

Practice address

344 University Blvd W
Suite 325
Silver Spring, MD 20901-1948

Phone

(301) 593-5440

Fax

(301) 593-5501

NPI assigned

Jul 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC

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

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
• Direct secure messaging: maiya.clark.1@8042.direct.athenahealth.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.

• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480

  DC, Pediatrics

  Medicare reassignment NPD
• Sunshine Pediatrics

  • Primary Care Clinic/Center
  • Silver Spring, MD
  • NPI 1760668081
  NPD (past) Authorized official
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Nova Physician Wellness Center PLLC

  • Family Medicine Physician
  • Fairfax, VA
  • NPI 1215307400
  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311638400000",
    "number": "1295760908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 KEARNEY ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200172959",
            "telephone_number": "202-832-8152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 UNIVERSITY BLVD W",
            "address_2": "SUITE 325",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209011948",
            "telephone_number": "301-593-5440",
            "fax_number": "301-593-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MAIYA",
        "middle_name": "YETUNDE ELON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2011-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0061964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "406773800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clara S.P. Chan, MD, PC
• Clarity Rose Mental Health and Wellness Center, PLLC
• Clarity Speech and Cognition, LLC
• Bailey A Clark
• Kayla Cierra Elaine Clark
• Anika Clarke-Kingston
• Daniel H Clarke, M.D.
• Melissa Clarke
• Zulma M Clavell, LCADC
• Barbara Ann Claxton, M.S.W.

• Pediatrics Physician in Silver Spring, MD
• Providers in Silver Spring, MD by specialty
• Pediatrics Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; 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.