Stacey J Clarke, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

E5243 Issued in CA

Practice address

82013 Doctor Carreon Blvd Ste H
Indio, CA 92201-5832

Phone

(760) 610-8398

Fax

(442) 300-2925

NPI assigned

Jul 14, 2005

Last updated

Apr 16, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/10718/brand/3/csg/1/fhir/r4
• Direct secure messaging: stacey.clarke.1@10718.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Foot & Wound Care of Indio

  • Foot Surgery Podiatrist
  • Indio, CA
  • NPI 1295458941
  Medicare reassignment NPD
• Morrison Multi-Specialties Companies Inc

  dba San Diego Arthritis Medical Clinic

  • Rheumatology Physician
  • San Diego, CA
  • NPI 1154965093
  Medicare reassignment NPD
• Norris Morrison DPM Inc

  • Podiatrist
  • Corona, CA
  • NPI 1871095190
  Medicare reassignment NPD
• Clarke Podiatry, LLC

  • Foot & Ankle Surgery Podiatrist
  • Milton Freewater, OR
  • NPI 1790295228
  NPD Authorized official
• CVS Medical Group, Inc

  • Vascular & Interventional Radiology Physician
  • Montebello, CA
  • NPI 1346717824
  NPD (past)
• High Desert Limb Salvage Institute Podiatrist Corp

  • Podiatric Clinic/Center
  • Apple Valley, CA
  • NPI 1588132062

  Foot & Ankle Surgery

  NPD (past)

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1437157260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82013 DOCTOR CARREON BLVD STE H",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015832",
            "telephone_number": "760-610-8398",
            "fax_number": "442-300-2925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82013 DOCTOR CARREON BLVD STE H",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015832",
            "telephone_number": "760-610-8398",
            "fax_number": "442-300-2925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "STACEY",
        "middle_name": "J",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-14",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E5243",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OR",
            "license": "DP00283",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E5243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150541",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Ellisse Clark
• Henry R Clark
• Monica Clark
• Monica Clark
• Gilda Carlin Clarke
• Norma Clemente
• Claresha Clemons
• Clifford O Brown M.D., Inc
• Stephanie Irene , Rita Clifton
• Clinicas de Salud del Pueblo, Inc (Indio Health Clinic)

• Foot & Ankle Surgery Podiatrist in Indio, CA
• Providers in Indio, CA by specialty
• Foot & Ankle Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; 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.