Active NPI
Austin Jeremiah Sy Clark, MD
- Student in an Organized Health Care Education/Training Program
- Albuquerque, NM
National Provider Identifier
1811454184
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- RS2024-0223
- Practice address
- Msc09 5030 1 University of New Mexico
Albuquerque, NM 87131-0001 - Phone
- (505) 272-8244
- Fax
- (505) 272-4639
- NPI assigned
- Feb 22, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | A190369 | CA | |
| General Practice Physician | 208D00000X | MD2026-0243 | NM | |
| Student in an Organized Health Care Education/Training Program | 390200000X | RS2024-0223 | NM | Primary |
Addresses
Primary practice location
Msc09 5030 1 University of New Mexico
Albuquerque, NM 87131-0001
Mailing address
Msc09 5030 1 University of New Mexico
Albuquerque, NM 87131-0001
Other practice location 1
2335 Stockton Blvd
North Addition 5th Floor
Sacramento, CA 95817-2200
Phone (916) 734-2724
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 98
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A190369 | CA | MD | Surgery Physician |
| MD2026-0243 | NM | MD | General Practice Physician |
| RS2024-0223 | NM | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779926400000",
"number": "1811454184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MSC09 5030 1 UNIVERSITY OF NEW MEXICO",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871310001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MSC09 5030 1 UNIVERSITY OF NEW MEXICO",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871310001",
"telephone_number": "505-272-8244",
"fax_number": "505-272-4639"
}
],
"practiceLocations": [
{
"address_1": "2335 Stockton Blvd",
"address_2": "North Addition 5th Floor",
"address_purpose": "LOCATION",
"city": "Sacramento",
"state": "CA",
"postal_code": "958172200",
"country_code": "US",
"telephone_number": "916-734-2724",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CLARK",
"first_name": "AUSTIN",
"middle_name": "JEREMIAH SY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-02-22",
"last_updated": "2026-05-28",
"certification_date": "2026-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "A190369",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NM",
"license": "MD2026-0243",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NM",
"license": "RS2024-0223",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Albuquerque, NM
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; 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.