Todd Mathew Clark, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4992 Issued in OH

Practice address

395 N West St
Suite B
Westerville, OH 43082-1400

Phone

(614) 839-2733

Fax

(614) 839-5367

NPI assigned

Mar 19, 2007

Last updated

Dec 7, 2011By 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 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Ohio State University - College of Optometry, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Todd M. Clark, OD

  • Optometrist
  • Westerville, OH
  • NPI 1114195559
  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1831214196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 N WEST ST",
            "address_2": "SUITE B",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430821400",
            "telephone_number": "614-839-2733",
            "fax_number": "614-839-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 N WEST ST",
            "address_2": "SUITE B",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430821400",
            "telephone_number": "614-839-2733",
            "fax_number": "614-839-5367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TODD",
        "middle_name": "MATHEW",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL GOVERNMENT SERVICES - DMERC",
            "identifier": "1309550001",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Clark, BCBA
• Kimberly Clark, LMT
• Lisa Margaret Clark, LSW
• Patrice Sheree Clark
• Ryan Clark
• Kimberly Clayton
• Clearview Mental Health Inc
• John Cleghorn, NP
• Marc Gennaro Clemente, M.D.
• Nathaniel Clements

• Optometrist in Westerville, OH
• Providers in Westerville, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; 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.