Connor Clark

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00630600 Issued in NJ

Practice address

99 Beauvoir Ave
Summit, NJ 07901-3533

Phone

(908) 522-2000

NPI assigned

Jul 15, 2019

Last updated

Aug 6, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NJ

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Newton Emergency Medical Associates LLCGroup PAC ID 3678735057, 31 clinicians

Dimerhealth Medical PracticeGroup PAC ID 5991162257, 29 clinicians

Hackettstown Emergency Medical Associates, LLCGroup PAC ID 4688998990, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Newton Medical Center Hospital, Newton, NJ, CCN 310028

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: connor.clark.1@28989.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.

• Dimerhealth Medical Practice

  • Emergency Medicine Physician
  • Mendham, NJ
  • NPI 1285338483

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Hackettstown Emergency Medical Associates LLC

  • Emergency Medicine Physician
  • Hackettstown, NJ
  • NPI 1558768473
  Medicare reassignment Care Compare group
• Newton Emergency Medical Associates LLC

  • Emergency Medicine Physician
  • Newton, NJ
  • NPI 1306118344
  Medicare reassignment Care Compare group
• Emergency Physician Associates of North Jersey P C

  • Emergency Medicine Physician
  • Summit, NJ
  • NPI 1497783419
  Medicare reassignment
• Morristown Emergency Medical Associates LLC

  • Emergency Medicine Physician
  • Freehold, NJ
  • NPI 1649541087
  Medicare reassignment
• Dimer Health Services Inc

  • Emergency Medicine Physician
  • Mendham, NJ
  • NPI 1306540620

  Physician Assistant

  NPD

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

• Ahs Hospital Corp

  dba Newton Medical Center

  • General Acute Care Hospital
  • Newton, NJ
  • NPI 1790789212
  Care Compare affiliation

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

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1447802939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PRICE CT",
            "city": "DENVILLE",
            "state": "NJ",
            "postal_code": "078342176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 BEAUVOIR AVE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013533",
            "telephone_number": "908-522-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CONNOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-15",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00630600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ya Huei C Chu
• Jay Young Chun, MD
• Indra Cidambi, MD
• Charles P Ciolino, MD
• Kristine M Cisko, PA-C
• Julia Nicole Clayton, PT
• CM Medical Systems LLC
• Jacqueline A Co, MD
• Karen M Cocco, PHD
• Cognitive Therapy & Consultation LLC

• Physician Assistant in Summit, NJ
• Providers in Summit, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; 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.