Emily Clark, DO

Primary specialty

Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X

License

289091 Issued in NY

Practice address

300 Crittenden Blvd
Rochester, NY 14642-8409

Phone

(585) 275-6917

Fax

(585) 276-2292

NPI assigned

Apr 7, 2015

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

• Emily Justin Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NY

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

Psychiatry

Education

University of Kansas School of Med (KC/Wich/Sal), 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of RochesterGroup PAC ID 5799699088, 960 clinicians

Urmc Memory Care ProgramGroup PAC ID 9335320829, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Strong Memorial Hospital Hospital, Rochester, NY, CCN 330285

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ejustin102301@direct.urmc.rochester.edu

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.

• University of Rochester

  • Internal Medicine Physician
  • Rochester, NY
  • NPI 1710226824
  Medicare reassignment Care Compare group NPD
• Urmc Memory Care Program

  • Neurology Physician
  • Rochester, NY
  • NPI 1447565759
  Medicare reassignment Care Compare group NPD
• Acute Care Trauma of the University of Rochester

  • Surgical Critical Care Physician
  • Rochester, NY
  • NPI 1851754634
  NPD
• Cardiac Surgery of the University of Rochester

  • Surgical Critical Care Physician
  • Rochester, NY
  • NPI 1689023277
  NPD
• University of Rochester

  • Community/Retail Pharmacy
  • Rochester, NY
  • NPI 1598476269
  NPD
• University of Rochester

  • Internal Medicine Physician
  • Rochester, NY
  • NPI 1821152588
  NPD

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

• University of Rochester

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1346285657
  Care Compare affiliation
• University of Rochester

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1669126090
  Care Compare affiliation

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

{
    "created_epoch": "1428364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1588050587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CRITTENDEN BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146428409",
            "telephone_number": "585-275-6917",
            "fax_number": "585-276-2292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CRITTENDEN BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146428409",
            "telephone_number": "585-275-6917",
            "fax_number": "585-276-2292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "EMILY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-07",
        "last_updated": "2023-07-03",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NY",
            "license": "289091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ejustin102301@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ejustin102301@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "JUSTIN",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Catherine Celeste Clark, M.S., CCC-A
• Chaynna Clark, LMHC
• Crystal Clark
• Danielle Clark, NP
• Deborah Clark, RN
• Gregory D Clark, PT
• Gregory T Clark, RPH, BCOP
• Jadira Jannisse Clark
• James Clark, RPH
• John C Clark, CRNA

• Geriatric Psychiatry Physician in Rochester, NY
• Providers in Rochester, NY by specialty
• Geriatric Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.