Timothy A Clark, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

MD067096L Issued in PA

Practice address

2250 Millennium Way
Ste 400
Enola, PA 17025

Phone

(717) 724-2791

Fax

(717) 724-2797

NPI assigned

May 3, 2006

Last updated

Jul 6, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 PA

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

Specialty

Internal MedicineAlso: Critical Care (Intensivists)

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clearfield-Jefferson Primary Care Associates PCGroup PAC ID 6002064433, 73 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Compassus Hospice and Palliative Care - Philadelphia Hospice, Lancaster, PA, CCN 391695
• Milton S Hershey Medical Center Hospital, Hershey, PA, CCN 390256
• Concordia at Spiritrust Luther Ridge Nursing home, Chambersburg, PA, CCN 396146

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. 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.

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Clearfield-Jefferson Primary Care Associates PC

  • Family Medicine Physician
  • Du Bois, PA
  • NPI 1710233895
  Medicare reassignment Care Compare group NPD
• Central Pennsylvania Pulmonary Associates LLC

  • Pulmonary Disease Physician
  • Enola, PA
  • NPI 1356309223
  NPD Authorized official
• Sleep Disorder Centers of Central Pennsylvania, Inc.

  • Pulmonary Disease Physician
  • Enola, PA
  • NPI 1679594857
  NPD Authorized official

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

• Compassus Op of Pennsylvania LLC

  dba Compassus Hospice and Palliative Care -Philadelphia

  • Community Based Hospice Care Agency
  • Lancaster, PA
  • NPI 1225588486
  Care Compare affiliation
• Spiritrust Lutheran

  dba SpiriTrust Lutheran The Village at Luther Ridge

  • Skilled Nursing Facility
  • Chambersburg, PA
  • NPI 1588132716

  Nursing home

  Care Compare affiliation
• The Milton S Hershey Medical Center

  • General Acute Care Hospital
  • Hershey, PA
  • NPI 1568435477
  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": "1341532800000",
    "number": "1407814726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 MILLENNIUM WAY",
            "address_2": "STE 400",
            "city": "ENOLA",
            "state": "PA",
            "postal_code": "17025",
            "telephone_number": "717-724-2791",
            "fax_number": "717-724-2797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 MILLENNIUM WAY",
            "address_2": "STE 400",
            "city": "ENOLA",
            "state": "PA",
            "postal_code": "17025",
            "telephone_number": "717-724-2791",
            "fax_number": "717-724-2797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TIMOTHY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2012-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PA",
            "license": "MD067096L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001821036",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christensen Chiropractic
• Barbara Christensen, DC
• Thomas Chu, D.O.
• Daniel J Church, PA-C
• Jamie Clark, L.P.C.
• Cheyenne Courson
• Crumay Parnes Associates, Inc.
• Cumberland Family Practice ( a Division of Heritage Medical Group, LLP
• Cumberland Life LLC
• Renee Anne Cummings, OT

• Pulmonary Disease Physician in Enola, PA
• Providers in Enola, PA by specialty
• Pulmonary Disease Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.