Samuel J. Clark, M.D.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

A52335 Issued in CA

Practice address

1940 El Cajon Blvd
San Diego, CA 92104-1005

Phone

(619) 543-4500

Fax

(619) 295-5600

NPI assigned

May 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine

Education

Vanderbilt University School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Samuel J Clark MD IncGroup PAC ID 0547279499, 3 clinicians

SD Diagnostics IncGroup PAC ID 3870723950, 6 clinicians

Chest Medicine and Critical Care Medical Group IncGroup PAC ID 6103898259, 26 clinicians

Emergency and Acute Care Medical CorporationGroup PAC ID 9537108279, 431 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sharp Memorial Hospital Hospital, San Diego, CA, CCN 050100
• Scripps Mercy Hospital Hospital, San Diego, CA, CCN 050077

Merit-based Incentive Payment System (MIPS)

Final score

79.91 of 100Reported as group

Quality

73.46

Improvement activities

20

Cost

73.34

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Samuel J. Clark, M.D., Inc.

  • Pulmonary Disease Physician
  • San Diego, CA
  • NPI 1124079793
  Medicare reassignment Care Compare group NPD Authorized official
• Chest Medicine and Critical Care Medical Group, Inc.

  • Pulmonary Disease Physician
  • San Diego, CA
  • NPI 1841292521

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Emergency and Acute Care Medical Corporation

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1437103942
  Medicare reassignment Care Compare group NPD
• SD Diagnostics Inc

  • Sleep Disorder Diagnostic Clinic/Center
  • San Diego, CA
  • NPI 1003252834
  Medicare reassignment Care Compare group NPD
• KND Development 59 LLC

  • Hospitalist Physician
  • Santa Ana, CA
  • NPI 1740519081
  Medicare reassignment NPD
• KND Development 59 LLC

  • Hospitalist Physician
  • San Diego, CA
  • NPI 1881923951
  NPD
• KND Development 59, LLC

  • Hospitalist Physician
  • Broken Arrow, OK
  • NPI 1922950823
  NPD
• SD Diagnostics Inc

  • Sleep Disorder Diagnostic Clinic/Center
  • Austin, TX
  • NPI 1144909680
  NPD
• Acute Care Associates, Inc

  • Pulmonary Disease Physician
  • Encinitas, CA
  • NPI 1841387214
  NPD (past)
• Sharp Memorial Hospital

  • Rehabilitation Hospital Unit
  • San Diego, CA
  • NPI 1114901352
  NPD (past)

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

• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1659359446
  Care Compare affiliation
• Sharp Memorial Hospital

  • Rehabilitation Hospital Unit
  • San Diego, CA
  • NPI 1114901352
  Care Compare affiliation
• Sharp Memorial Hospital

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1407839921
  Care Compare affiliation

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1689611709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 881609",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921681609",
            "telephone_number": "619-794-2521",
            "fax_number": "619-794-2523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 EL CAJON BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921041005",
            "telephone_number": "619-543-4500",
            "fax_number": "619-295-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SAMUEL",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A52335",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "A52335",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "CA",
            "license": "A52335",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A52335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Ray Clark, M.D.
• Paula K Clark, MA
• Rachel Lee Clark, RN
• Richard F Clark, PA
• Roberta Clark, RDHAP, MS
• Serena Adriana Clark
• Sollie Grace Clark
• Susan Elizabeth Clark, M.A.
• Taylor Clark, PHD
• Vivian L Clark, RDH

• Pulmonary Disease Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Pulmonary Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.