Organization Active NPI

Colin Clarke M.D. P.C.

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1487760963
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
208242-8 Issued in NY
Legal business name
COLIN CLARKE M.D. P.C.
Practice address
2518 Ocean Ave
Brooklyn, NY 11229-3916
Phone
(718) 934-5395
NPI assigned
Aug 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Colin Clarke, M.D.
Title
President
Phone
(516) 456-8077

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 208242-8 NY Primary

Addresses

Primary practice location

2518 Ocean Ave
Brooklyn, NY 11229-3916

Mailing address

PO Box 350185
Brooklyn, NY 11235-0185
Phone (718) 743-6225

Other identifiers 1

IdentifierTypeStateIssuer
02317435MedicaidNY

National Provider Directory

National Provider Directory

Locations

27 The Plz
Locust Valley, NY 11560
Phone (516) 456-8077

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487760963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 350185",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112350185",
            "telephone_number": "718-743-6225",
            "fax_number": "866-317-2671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2518 OCEAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112293916",
            "telephone_number": "718-934-5395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLIN CLARKE M.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "COLIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-456-8077",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "208242-8",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02317435",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.