Robert Thomas Clark, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

4301040778 Issued in MI

Practice address

7575 Grand River Rd
Ste 111
Brighton, MI 48114-9390

Phone

(810) 844-7744

Fax

(810) 844-7725

NPI assigned

Jun 9, 2005

Reactivated

Mar 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

91.34 of 100Reported as group

Quality

100

Improvement activities

40

Cost

71.12

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: rclark37408@direct.trinity-health.org
• Direct secure messaging: drclark@clarkeye.direct.eyemdemr.com
• Direct secure messaging: rclark@direct.dmc.org

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216166400000",
    "number": "1386648087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1252 HIDDEN LAKE DR",
            "city": "BLOOMFIELD",
            "state": "MI",
            "postal_code": "483021955",
            "telephone_number": "248-258-1967",
            "fax_number": "248-258-5868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7575 GRAND RIVER RD",
            "address_2": "STE 111",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481149390",
            "telephone_number": "810-844-7744",
            "fax_number": "810-844-7725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ROBERT",
        "middle_name": "THOMAS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2008-07-16",
        "deactivation_date": "2006-03-15",
        "reactivation_date": "2006-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301040778",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4301040778",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS REFERRING",
            "identifier": "RC040778",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIV PIN",
            "identifier": "1804701481",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4301040778",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2681557",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM OPTOMETRIC GROUP",
            "identifier": "900D710610",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leigh Christie, D.O.
• Christine a. Love D.D.S., M.S. PLC
• Johanna M Ciak, M.S.W.
• Thomas Thatcher Claflin, DDS
• Jordan Clark, DC
• Classic Home Care-Livingston, Inc.
• Suzanne Marie Cleck, MSW LMSW
• Nicole Marie Clement, DPT
• Tyler Clincher
• Katharine Cline

• Ophthalmology Physician in Brighton, MI
• Providers in Brighton, MI by specialty
• Ophthalmology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.