Andrew Clark, MD, PHD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

A163607 Issued in CA

Practice address

1450 San Pablo St FL 4
Los Angeles, CA 90033-5331

Phone

(323) 442-6335

NPI assigned

Jun 25, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Ophthalmology

Education

University of Southern California Keck School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

California Retina Consultants 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Santa Barbara Cottage Hospital Hospital, Santa Barbara, CA, CCN 050396
• Henry Mayo Newhall Hospital Hospital, Valencia, CA, CCN 050624

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

Practice roles (11 of 12)

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: aclark@caretina.intellechartdirect.net
• Direct secure messaging: aclark760836@hisp.ehr.sutterhealth.org

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.

• California Retina Consultants

  • Retina Specialist (Ophthalmology) Physician
  • Bakersfield, CA
  • NPI 1083757322

  CA

  Medicare reassignment Care Compare group NPD
• California Retina Consultants

  • Retina Specialist (Ophthalmology) Physician
  • San Luis Obispo, CA
  • NPI 1144405309

  CA

  Medicare reassignment Care Compare group NPD
• Sansum Clinic

  • Multi-Specialty Clinic/Center
  • Santa Barbara, CA
  • NPI 1154354504

  CA

  Medicare reassignment NPD
• Usc Care Medical Group, Inc

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1902846306

  CA, Ophthalmology

  Medicare reassignment NPD
• California Retina Consultants

  • Retina Specialist (Ophthalmology) Physician
  • Santa Barbara, CA
  • NPI 1386737617
  NPD
• California Retina Consultants

  • Retina Specialist (Ophthalmology) Physician
  • Visalia, CA
  • NPI 1750641775
  NPD
• Sansum Clinic

  • Ambulatory Surgical Clinic/Center
  • Santa Barbara, CA
  • NPI 1144648015
  NPD
• Sansum Clinic

  • Multi-Specialty Clinic/Center
  • Santa Barbara, CA
  • NPI 1932121514
  NPD
• Usc Care Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Pasadena, CA
  • NPI 1427937390
  NPD
• California Retina Consultants

  • Retina Specialist (Ophthalmology) Physician
  • Palmdale, CA
  • NPI 1194868398
  NPD (past)
• Sansum Clinic

  • Ambulatory Surgical Clinic/Center
  • Santa Barbara, CA
  • NPI 1649296807
  NPD (past)

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

• Henry Mayo Newhall Memorial Hospital

  • General Acute Care Hospital
  • Valencia, CA
  • NPI 1780668434

  Hospital

  Care Compare affiliation
• Santa Barbara Cottage Hospital

  • General Acute Care Hospital
  • Santa Barbara, CA
  • NPI 1477554152

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1447745336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 SAN PABLO ST FL 4",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 SAN PABLO ST FL 4",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335331",
            "telephone_number": "323-442-6335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 W California Blvd",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911053010",
            "country_code": "US",
            "telephone_number": "626-421-7733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ANDREW",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-25",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A163607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "andrew.clark@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1520 San Pablo St",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900335310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cynthia Clark-Lyles, MA
• Abigail Clark
• Ahyana Clark
• Alicia Suzanne Clark, MPAP, PA-C
• Amara Candace Clark
• Anna Clark, M.A., CCC-SLP
• Barbara Latrease Clark, PA-C
• Bonnie Marie Clark
• Charae J Clark
• Cherise Clark, PHARMD

• All providers in Los Angeles, CA
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.