Devin Clark, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

P107563 Issued in NY

Practice address

1160 Teller Ave
Bronx, NY 10456-4291

Phone

(718) 293-1500

NPI assigned

Apr 9, 2017

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

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• My Medical PC

  • Family Medicine Physician
  • Valley Cottage, NY
  • NPI 1518637891

  Internal Medicine

  Medicare reassignment NPD
• Peyman Younesi MD PLLC

  • Internal Medicine Physician
  • Fresh Meadows, NY
  • NPI 1891053328
  Medicare reassignment NPD

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

{
    "created_epoch": "1491696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1760915425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3438 BELL BLVD STE 301",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113611739",
            "telephone_number": "187-709-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 TELLER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104564291",
            "telephone_number": "718-293-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2915 Williamsbridge Rd",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104678603",
            "country_code": "US",
            "telephone_number": "718-655-3433",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14040 Sanford Ave",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113552556",
            "country_code": "US",
            "telephone_number": "718-353-1495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DEVIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-09",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "P107563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bianca Clark, D.D.S
• Bradley C Clark, MD
• Bridgette Anna Clark
• Crystal Clark
• David Clark
• Elizabeth Morrigan Clark, M.D.
• Esteban Clark, LMSW
• Gian Louis Clark
• Jennifer Isabel Clark
• Julia Silva Clark

• Internal Medicine Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.