NPIMap

Individual provider Active NPI

Clark D. Haber, MD

  • Emergency Medicine Physician
  • Far Rockaway, NY
National Provider Identifier
1639189905
Registry record updated Sep 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
129871 Issued in NY
Practice address
5115 Beach Channel Dr
Peninsula Hospital Center
Far Rockaway, NY 11691-1042
Phone
(718) 734-2700
NPI assigned
Aug 9, 2006
Last updated
Sep 15, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 129871 NY Primary

Addresses

Primary practice location

5115 Beach Channel Dr
Peninsula Hospital Center
Far Rockaway, NY 11691-1042

Mailing address

5115 Beach Channel Dr
Peninsula Hospital Center
Far Rockaway, NY 11691-1042
Phone (718) 734-2700

Other identifiers 1

IdentifierTypeStateIssuer
01427292MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040315001239 NY Practitioner - Emergency MedicinePractitioner - Family Practice 3678462637 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Family Practice
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronx Medical Practice PCGroup PAC ID 9739496100, 136 clinicians

Practice addresses (Care Compare)

2015 Grand Concourse
Bronx, NY 10453-4303
Phone (718) 299-7295

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Bronx Medical Practice P.C. CurrentSince Aug 11, 2025 Accepting new patients
Essen Medical Associates, PC CurrentSince Aug 11, 2025 Accepting new patients
Essen Medical Associates, PC CurrentSince Aug 11, 2025 Accepting new patients
House Call Medical Services of New York, PLLC CurrentSince Aug 11, 2025 Accepting new patients
LH Emergency Medical Services PC Emergency Medicine Past Accepting new patients
Caritas Emergency Medical Services, PC Emergency Medicine Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Caritas Emergency Medical Services, PC Emergency Medicine Past Accepting new patients
Peninsula Medical Services PC Emergency Medicine Past Accepting new patients
KHH Emergency Medicine Emergency Medicine Past Accepting new patients
Beth Israel Medical Center Emergency Medicine Past Accepting new patients
Beth Israel Medical Center Past Accepting new patients

Locations

1371 Seabury Ave
Bronx, NY 10461
Phone (718) 294-6200

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284508800000",
    "number": "1639189905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 BEACH CHANNEL DR",
            "address_2": "PENINSULA HOSPITAL CENTER",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116911042",
            "telephone_number": "718-734-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 BEACH CHANNEL DR",
            "address_2": "PENINSULA HOSPITAL CENTER",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116911042",
            "telephone_number": "718-734-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABER",
        "first_name": "CLARK",
        "middle_name": "D.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2010-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "129871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01427292",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

Verify at the official NPI Registry.