NPIMap

Organization Active NPI

Doctors McClow Clark & Berk PA

Doing business as MCB Radiology

  • Diagnostic Radiology Physician
  • Jacksonville, FL
National Provider Identifier
1669420436
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
DOCTORS MCCLOW CLARK & BERK PA
Doing business as
MCB Radiology
Practice address
1 Shircliff Way
Jacksonville, FL 32204-4748
Phone
(904) 308-7300
NPI assigned
May 4, 2006
Last updated
May 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Authorized official

Name
Dr. Ario Rezaei, MDNPI 1417158452
Title
President
Phone
(904) 388-6949

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

1 Shircliff Way
Jacksonville, FL 32204-4748

Mailing address

PO Box 161180
Altamonte Springs, FL 32716-1180
Phone (904) 388-6949

Other practice location 1

1800 Barrs St
Jacksonville, FL 32204-4704
Phone (904) 388-6949

Other identifiers 9

IdentifierTypeStateIssuer
051598104MedicaidFL
051598100MedicaidFL
051598107MedicaidFL
051598105MedicaidFL
051598108MedicaidFL
300037068AMedicaidGA
00308OtherFLBC BS OF FLORIDA
CF1461OtherFLRR MEDICARE
051598106MedicaidFL

Other names 1

  • MCB Radiology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL, SC, GA, PR5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
O20050610000147 FL Part B Supplier - Clinic/Group Practice 4587607577 Receives reassigned benefits from 31 practitioners
Practice locations: Jacksonville, FL; Key Largo, FL; Middleburg, FL; Ponte Vedra Beach, FL; Saint Johns, FL; Atlantic Beach, FL; Fleming Island, FL; Gainesville, FL
O20201218002283 AL Part B Supplier - Clinic/Group Practice 4587607577 Receives reassigned benefits from 2 practitioners
Practice locations: Birmingham, AL; Vestavia, AL
O20211111001365 SC Part B Supplier - Clinic/Group Practice 4587607577 Receives reassigned benefits from 1 practitioner
Practice locations: North Augusta, SC
O20211202000251 GA Part B Supplier - Clinic/Group Practice 4587607577 Receives reassigned benefits from 1 practitioner
Practice locations: Eatonton, GA
O20260618000072 PR Part B Supplier - Clinic/Group Practice 4587607577 Receives reassigned benefits from 1 practitioner
Practice locations: Dorado, PR

National Provider Directory

National Provider Directory

Locations

6699 Gate Pkwy
Jacksonville, FL 32256
Phone (904) 375-9753

6699 Gate Pkwy
Ste C
Jacksonville, FL 32256
Phone (904) 710-3195

1726 Jeremiah St
Middleburg, FL 32068
Phone (904) 710-3195

1786 Blanding Blvd
Ste K2
Middleburg, FL 32068

1786 Blanding Blvd
Ste K2B
Middleburg, FL 32068
Phone (904) 450-6940

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779926400000",
    "number": "1669420436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 161180",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327161180",
            "telephone_number": "904-388-6949",
            "fax_number": "904-388-1841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SHIRCLIFF WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044748",
            "telephone_number": "904-308-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Barrs St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322044704",
            "country_code": "US",
            "telephone_number": "904-388-6949",
            "fax_number": "904-388-1841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DOCTORS MCCLOW CLARK & BERK PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A",
        "authorized_official_last_name": "REZAEI",
        "authorized_official_first_name": "ARIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-388-6949",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051598104",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051598100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051598107",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051598105",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051598108",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300037068A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC  BS OF FLORIDA",
            "identifier": "00308",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CF1461",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051598106",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCB Radiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.