Seth Clark

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

License

MD15837 Issued in RI

Practice address

200 Corliss St
Providence, RI 02904

Phone

(401) 606-8530

Fax

(401) 606-8549

NPI assigned

May 27, 2014

Last updated

Jun 24, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

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

Addiction Medicine

Education

University of Texas Medical Branch at Galveston, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rhode Island HospitalGroup PAC ID 8921900044, 430 clinicians

Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rhode Island Hospital Hospital, Providence, RI, CCN 410007

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sclark16396@brownhealth.medalliesdirect.net

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.

• Lifespan Physician Group, Inc.

  dba Brown Health Medical Group

  • Psychiatry Physician
  • Providence, RI
  • NPI 1548506793

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Rhode Island Hospital

  • Multi-Specialty Clinic/Center
  • Providence, RI
  • NPI 1154537520
  Medicare reassignment Care Compare group NPD
• Gateway Healthcare Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pawtucket, RI
  • NPI 1821078932

  Multi-Specialty

  Medicare reassignment NPD
• Lifespan Corporation

  • Children's Rehabilitation Hospital
  • Providence, RI
  • NPI 1790221232
  NPD
• Lifespan Physician Group, Inc.

  dba Brown Health Medical Group

  • Emergency Medicine Physician
  • Providence, RI
  • NPI 1568325678

  Multi-Specialty

  NPD
• Rhode Island Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1588659528
  NPD (past)

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

• Rhode Island Hospital

  dba LifePact

  • Ambulance
  • Providence, RI
  • NPI 1053552299

  Hospital

  Care Compare affiliation
• Rhode Island Hospital

  • Clinic/Center
  • Providence, RI
  • NPI 1154663383

  Hospital

  Care Compare affiliation
• Rhode Island Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1588659528
  Care Compare affiliation
• Rhode Island Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1972768174
  Care Compare affiliation

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

{
    "created_epoch": "1401148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1801208798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054513",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CORLISS ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02904",
            "telephone_number": "401-606-8530",
            "fax_number": "401-606-8549"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "593 Eddy St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-444-4741",
            "fax_number": "401-444-4445",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Corliss St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "02904",
            "country_code": "US",
            "telephone_number": "401-606-8530",
            "fax_number": "401-606-8549",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1052 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Cranston",
            "state": "RI",
            "postal_code": "029103225",
            "country_code": "US",
            "telephone_number": "401-461-5056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SETH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-27",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD15837",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "RI",
            "license": "MD15837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan B. Clark, CRNA
• Kerry A Clark, NP
• Kristen M Clark, NP
• Madelyn Isabel Clark
• Michael Clark, NP
• Tor Clark, PA-C
• Michael Clarke, AU.D.
• Nicole Clarke
• Ronald E Clary Jr., D.C.
• Estefania Clavijo, LCSW

• Addiction Medicine (Internal Medicine) Physician in Providence, RI
• Providers in Providence, RI by specialty
• Addiction Medicine (Internal Medicine) Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.