Peter Clark, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A68635 Issued in CA

Practice address

85 Sierra Park Rd
Mammoth Lakes, CA 93546-0660

Phone

(760) 934-2551

Fax

(760) 924-4081

NPI assigned

Jan 25, 2007

Last updated

Mar 7, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 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

Specialty

Family Practice

Education

Temple University School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Mono Health Care DistrictGroup PAC ID 9830002401, 94 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pioneer Home Health Care Home health agency, Bishop, CA, CCN 557008
• Mammoth Hospital Hospital, Mammoth Lakes, CA, CCN 051303
• Northern Inyo Hospital Hospital, Bishop, CA, CCN 051324
• Barton Memorial Hospital Hospital, South Lake Tahoe, CA, CCN 050352

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Southern Mono Health Care District

  dba Mammoth Hospital

  • Critical Access Hospital Clinic/Center
  • Mammoth Lakes, CA
  • NPI 1962444059
  Medicare reassignment Care Compare group NPD
• Southern Mono Health Care District

  dba Bridgeport Family Medicine Clinic

  • Rural Acute Care Hospital
  • Bridgeport, CA
  • NPI 1821149816
  NPD

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

• Barton Healthcare System

  dba Barton Memorial Hospital

  • General Acute Care Hospital
  • South Lake Tahoe, CA
  • NPI 1003867565
  Care Compare affiliation
• Northern Inyo Healthcare District

  dba Northern Inyo Hospital

  • Critical Access Hospital
  • Bishop, CA
  • NPI 1922198712
  Care Compare affiliation
• Pioneer Home Health Care, Inc.

  • Home Health Agency
  • Bishop, CA
  • NPI 1790782241
  Care Compare affiliation
• Southern Mono Health Care District

  dba Mammoth Hospital

  • Critical Access Hospital Clinic/Center
  • Mammoth Lakes, CA
  • NPI 1962444059
  Care Compare affiliation

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362614400000",
    "number": "1528113628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660",
            "address_2": "85 SIERRA PARK RD",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "935460660",
            "telephone_number": "760-923-4255",
            "fax_number": "760-924-4081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 SIERRA PARK RD",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "935460660",
            "telephone_number": "760-934-2551",
            "fax_number": "760-924-4081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2013-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A68635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lavaree Chavez
• Sara Chavez, PHYSICAL THERAPIST
• Melvin Cherne, MD
• Sabrina Noelle Cimerol, D.M.D
• Judith Z Clark, PHD
• Roger L Claypool, M.D.
• Brittania Cogan
• James Albert Cole, RPT
• Kristin Elizabeth Collins, DO
• Christopher John Comfort, DDS, FAGD, AAACD

• Family Medicine Physician in Mammoth Lakes, CA
• Providers in Mammoth Lakes, 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 7, 2013; 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.