Michael G Clark, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA00339 Issued in TX

Practice address

1305 Airport Fwy Ste 305
Bedford, TX 76021-6604

Phone

(817) 545-1355

Fax

(817) 545-1574

NPI assigned

May 3, 2006

Sex

Male

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 6

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heart Center of North Texas PAGroup PAC ID 5092798694, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medical City Weatherford Hospital, Weatherford, TX, CCN 450203
• Palo Pinto General Hospital Hospital, Mineral Wells, TX, CCN 450565

Merit-based Incentive Payment System (MIPS)

Final score

86.96 of 100Reported as group

Quality

81.53

Promoting interoperability

100

Improvement activities

40

Cost

74.99

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael.clark@direct.hcnt.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.

• Heart Center of North Texas, PA

  • Cardiovascular Disease Physician
  • Weatherford, TX
  • NPI 1821202581
  Medicare reassignment Care Compare group NPD
• Physicians and Allied Health Professionals Group, PA

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1528011814
  NPD (past)

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

• Palo Pinto County Hospital District

  • General Acute Care Hospital
  • Mineral Wells, TX
  • NPI 1972590602
  Care Compare affiliation
• Weatherford Health Services, LLC

  • General Acute Care Hospital
  • Weatherford, TX
  • NPI 1417471467
  Care Compare affiliation

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1326006834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 AIRPORT FWY STE 305",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760216604",
            "telephone_number": "817-545-1355",
            "fax_number": "817-545-1574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 AIRPORT FWY STE 305",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760216604",
            "telephone_number": "817-545-1355",
            "fax_number": "817-545-1574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA00339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196349801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196349804",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8N2840",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196349803",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00297373",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196349802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Bedford, TX
• Providers in Bedford, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; 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.