Cynthia Lynne Clark, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A060094 Issued in CA

Practice address

468 Ellis St
San Francisco, CA 94102-1928

Phone

(650) 227-1150

Fax

(650) 227-1107

NPI assigned

Jun 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Cynthia Lynne Clark-Segelke Other name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• One Medical Group, Inc.

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1467781641
  Medicare reassignment NPD
• One Medical Group, Inc

  • Family Medicine Physician
  • Tigard, OR
  • NPI 1891521134
  NPD

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1487690244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 SUTTER ST FL 2",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941044009",
            "telephone_number": "154-658-6791",
            "fax_number": "415-520-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "468 ELLIS ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941021928",
            "telephone_number": "650-227-1150",
            "fax_number": "650-227-1107"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "270 Grant Ave",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943061911",
            "country_code": "US",
            "telephone_number": "650-327-1223",
            "fax_number": "650-327-8572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CYNTHIA",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A060094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CYNTHIA",
            "last_name": "CLARK-SEGELKE",
            "middle_name": "LYNNE",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Caitlin M. Clark, MD
• Carol A Clark, MSPT
• Christen Elizabeth Clark, RN
• Christina Macdonald Fraser Clark, MSN.FNP
• Corey Clark
• David Clark, CMT
• Edith Clark
• Eric Deon Clark, SUDCC
• Glen Antonio Clark III
• Heather Clark

• Family Medicine Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; 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.