Sheryl Diane Clark, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

176093 Issued in NY

Practice address

109 E 61 St
New York, NY 10021

Phone

(212) 750-2905

Fax

(212) 888-0930

NPI assigned

Sep 20, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2025 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Michael L Lewin MD PC

  • Allergy Physician
  • New York, NY
  • NPI 1720256639
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508963422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 E 61 ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10021",
            "telephone_number": "212-750-2905",
            "fax_number": "212-888-0930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 E 61 ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10021",
            "telephone_number": "212-750-2905",
            "fax_number": "212-888-0930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SHERYL",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "176093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Caleb Clark, MD
• Rachel Ann Clark
• Rebecca Clark
• Rebecca (Becky) A Clark, PHD, LCSW-R, CC-AASP
• Roger Clark
• Siobhan Clark, LMSW
• Stephen David Clark, M.D.
• Taylor Rebecca Clark, N.P
• Lovelett Clarke - Palmer, RN
• Clarke School for the Deaf, the

• Dermatology Physician in New York, NY
• Providers in New York, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.