Individual provider Active NPI

Adam J Clemens, MD

  • Urology Physician
  • Newark, OH
National Provider Identifier
1477798049
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
35-122927 Issued in OH
Practice address
1980 Tamarack Rd
Newark, OH 43055-1363
Phone
(220) 564-7520
Fax
(220) 564-7521
NPI assigned
Dec 10, 2008
Last updated
Sep 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 35-122927 OH Primary

Addresses

Primary practice location

1980 Tamarack Rd
Newark, OH 43055-1363

Mailing address

1980 Tamarack Rd
Newark, OH 43055-1363
Phone (220) 564-7520

Other practice location 1

629 N Sandusky Ave
Bucyrus, OH 44820-1821
Phone (419) 468-0732

Other practice location 2

715 Richland Mall
Ontario, OH 44906-3802
Phone (419) 468-0732

Other identifiers 1

IdentifierTypeStateIssuer
0099799MedicaidOH

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address aclemens43699@lickingmemorial.medicity.net Licking Memorial Professional Corporation
Direct Messaging Address aclemens684753@direct.osumc.edu
Direct Messaging Address aclemens684753@direct.osumc.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20140528002169 OH Practitioner - Urology 3476797259 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Medical College of Ohio, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1980 Tamarack Rd
Newark, OH 43055-1363
Phone (220) 564-7520

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35-122927OHMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Licking Memorial Health Professionals Current Accepting new patients
Licking Memorial Professional Corporation CurrentSince Sep 3, 2025 Accepting new patients
Florida Physician Specialists LLC Current Accepting new patients
Premier Urology Corp Urology CurrentSince Apr 7, 2014 Accepting new patients
Licking Memorial Professional Corporation CurrentSince Sep 3, 2025 Accepting new patients
Knox Community Hospital Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Licking Memorial Professional Corp. Past Accepting new patients
Licking Memorial Professional Corp. Past Accepting new patients

Locations

710 Lomax St
Jacksonville, FL 32204
Phone (904) 306-6781

120 McMillen Dr
Newark, OH 43055
Phone (220) 564-4806

1320 W Main St
Newark, OH 43055
Phone (740) 348-4151

1980 Tamarack Rd
Newark, OH 43055
Phone (220) 564-7520

430 Altair Pkwy
Ste 200
Westerville, OH 43082
Phone (614) 818-0215

477 Cooper Rd
Ste 220
Westerville, OH 43081
Phone (614) 818-0215

Interoperability endpoints

  • Direct secure messaging: aclemens684753@direct.osumc.edu

Organizations & group practices 9

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1228867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1477798049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1980 TAMARACK RD",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551363",
            "telephone_number": "220-564-7520",
            "fax_number": "220-564-7521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1980 TAMARACK RD",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551363",
            "telephone_number": "220-564-7520",
            "fax_number": "220-564-7521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "629 N Sandusky Ave",
            "address_purpose": "LOCATION",
            "city": "Bucyrus",
            "state": "OH",
            "postal_code": "448201821",
            "country_code": "US",
            "telephone_number": "419-468-0732",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "715 Richland Mall",
            "address_purpose": "LOCATION",
            "city": "Ontario",
            "state": "OH",
            "postal_code": "449063802",
            "country_code": "US",
            "telephone_number": "419-468-0732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEMENS",
        "first_name": "ADAM",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-10",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "35-122927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0099799",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aclemens43699@lickingmemorial.medicity.net",
            "affiliation": "Y",
            "affiliationName": "Licking Memorial Professional Corporation",
            "address_1": "1980 Tamarack Rd",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430551363",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aclemens684753@direct.osumc.edu",
            "affiliation": "N",
            "address_1": "629 N Sandusky Ave",
            "city": "Bucyrus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "448201821",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aclemens684753@direct.osumc.edu",
            "affiliation": "N",
            "address_1": "715 Richland Mall",
            "city": "Ontario",
            "state": "OH",
            "country_code": "US",
            "postal_code": "449063802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

Verify at the official NPI Registry.