Dane E Clarke, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

25MA06703000 Issued in NJ

Practice address

530 New Brunswick Ave
Perth Amboy, NJ 08861-3674

Phone

(732) 442-3700

NPI assigned

Aug 9, 2005

Last updated

Mar 6, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL

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

Emergency Medicine

Education

Lincoln Medical College, Eclectic, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoenix Emergency Medicine of Broward LLCGroup PAC ID 5991793002, 69 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Broward Health Imperial Point Hospital, Fort Lauderdale, FL, CCN 100200

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

Locations

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.

• Phoenix Emergency Medicine of Broward LLC

  • Emergency Medicine Physician
  • Coral Springs, FL
  • NPI 1871542969
  Medicare reassignment Care Compare group NPD
• Phoenix Emergency Medicine of Broward LLC

  • Emergency Medicine Physician
  • Deerfield Beach, FL
  • NPI 1407805591
  NPD
• Phoenix Emergency Medicine of Broward LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1598714685
  NPD
• Emergency Associates of the North Ward, P.a.

  • Emergency Medicine Physician
  • Newark, NJ
  • NPI 1235130238
  NPD (past)
• Essex Emergency Associates, P.a.

  • Emergency Medicine Physician
  • Newark, NJ
  • NPI 1083615090
  NPD (past)

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

• North Broward Hospital District

  dba Broward Health Imperial Point

  • General Acute Care Hospital
  • Fort Lauderdale, FL
  • NPI 1265460232
  Care Compare affiliation

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425600000000",
    "number": "1710988050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 W GILBERT ST",
            "address_2": "2ND FL",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077014918",
            "telephone_number": "721-212-0060",
            "fax_number": "732-212-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NEW BRUNSWICK AVE",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613674",
            "telephone_number": "732-442-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "DANE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2015-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA06703000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD CARRIER",
            "identifier": "P00603903",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHP NON-PAR#",
            "identifier": "26085",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7502907",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• City of Perth Amboy
• Clarity Treatment Center LLC
• Clarity Treatment Center, LLC
• Clarity Treatment Services, LLC
• Clarity Treatment Services, LLC
• Laila Colicchio, O.D.
• Community Pharmacy LLC
• Gabriela Andrea Concepcion Corcino, DC
• Confident Care Corp
• Convery Dental Associates

• Emergency Medicine Physician in Perth Amboy, NJ
• Providers in Perth Amboy, NJ by specialty
• Emergency Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2015; 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.