Individual provider Active NPI

Deborah A Clarke, MD

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1629038583
Registry record updated May 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD429888 Issued in PA
Practice address
760 Carpenter LN
Philadelphia, PA 19119-3406
Phone
(215) 848-6880
Fax
(215) 848-3333
NPI assigned
Mar 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD429888 PA Primary

Addresses

Primary practice location

760 Carpenter LN
Philadelphia, PA 19119-3406

Mailing address

760 Carpenter LN
Philadelphia, PA 19119-3406
Phone (215) 848-6880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20101004000289 PA Practitioner - Family Practice 1850583311 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Medexpress Urgent Care, PC - Pennsylvania CurrentSince Aug 8, 2017 Accepting new patients
Urgent Care, PC - Pennsylvania Current Accepting new patients
Medexpress Urgent Care, PC - Pennsylvania CurrentSince Aug 8, 2017 Accepting new patients
Lumberton Family Physicians, LLC Family Medicine Past Accepting new patients
Ashurst Family Physicians, PA Family Medicine Past Accepting new patients

Locations

4808 Edgmont Ave
Brookhaven, PA 19015
Phone (610) 876-3072

7219 McKnight Rd
Ste F
Pittsburgh, PA 15237
Phone (412) 367-3278

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493856000000",
    "number": "1629038583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 CARPENTER LN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191193406",
            "telephone_number": "215-848-6880",
            "fax_number": "215-848-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 CARPENTER LN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191193406",
            "telephone_number": "215-848-6880",
            "fax_number": "215-848-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "DEBORAH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2017-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD429888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.