Richard Travis Clark, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD2018-0142 Issued in NM

Practice address

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719

Phone

(505) 272-1476

NPI assigned

Jan 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 8

Electronic endpoints 4

Medicare fee-for-service enrollment

Enrolled in NM

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

Diagnostic Radiology

Education

Baylor College of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Unm Medical Group IncGroup PAC ID 4981795267, 1,052 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Unm Hospital Hospital, Albuquerque, NM, CCN 320001

Merit-based Incentive Payment System (MIPS)

Final score

89.64 of 100Reported as group

Quality

75.49

Promoting interoperability

100

Improvement activities

40

Cost

76.92

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.

• Unm Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Albuquerque, NM
  • NPI 1831218627
  Medicare reassignment Care Compare group NPD
• Unm Medical Group, Inc.

  dba UNM Truman Health Services Pharmacy

  • Community/Retail Pharmacy
  • Albuquerque, NM
  • NPI 1417330044
  NPD
• Multicare Health System

  dba MultiCare Deaconess Retail Pharmacy

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD (past)
• Radia Inc P S

  dba Radia

  • Diagnostic Radiology Physician
  • Lynnwood, WA
  • NPI 1700045572
  NPD (past)

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

• Unm Hospital

  • Air Ambulance
  • Albuquerque, NM
  • NPI 1558054684

  Hospital

  Care Compare affiliation
• Unm Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1689747552
  Care Compare affiliation

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1568432557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BRADBURY DR SE STE 116",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064310",
            "telephone_number": "505-272-1476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 LOMAS BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062719",
            "telephone_number": "505-272-1476"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19020 33rd Ave W",
            "address_2": "Suite 210",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980364748",
            "country_code": "US",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "RICHARD",
        "middle_name": "TRAVIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD60212011",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NM",
            "license": "MD2018-0142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2017034",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I SWEDISH RADIA EDMONDS",
            "identifier": "0365599",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568432557",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0293210",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I RADIA-KING COUNTY",
            "identifier": "0365598",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I EVERGREEN RADIA",
            "identifier": "0365600",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "158600",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I RADIA-REST OF WA",
            "identifier": "0365595",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMCCC@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "1201 Camino De Salud NE",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871024517",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMH@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "2211 Lomas Blvd NE",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871062719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "SRMC@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "3001 Broadmoor Blvd NE",
            "city": "Rio Rancho",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871442100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMMG@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "800 Bradbury Dr SE Ste 116",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871064310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lance D. Clark, DMD
• Marnice Clark
• Monika Clark, LADAC
• Pamela Clark
• Rebecca Jand Clark, LPCC, CRC
• Ross Clark, MD
• Sabrina Clark
• Serina Clark
• Shane Thomas Clark, DMD
• Sonja Dana Clark, PSYD, LPCC

• Diagnostic Radiology Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Diagnostic Radiology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; 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.