Bennett William Clark, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

62233 Issued in MN

Practice address

9 W Broad St Ste 320
Stamford, CT 06902-3758

Phone

(475) 251-8856

NPI assigned

Apr 20, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 9, 2025 through Jun 9, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1831416569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 W BROAD ST STE 320",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 W BROAD ST STE 320",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023758",
            "telephone_number": "475-251-8856"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2450 Riverside Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554541450",
            "country_code": "US",
            "telephone_number": "612-672-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 N Wolfe St",
            "address_2": "NELSON 215",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212870005",
            "country_code": "US",
            "telephone_number": "410-502-2128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "BENNETT",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-20",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0075366",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "54459",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "62233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City of Stamford, DHSS
• John Michael Ciuffo, RPH, JD
• Clabaugh & Trentalancia, PC
• Craig C. Clabaugh, DMD
• Clarity Mental Health, Inc
• Chelsea Marie Clark, PA-C
• Justin Liam Clark, DPT
• Michelle Allison Clark, F.N.P.
• Sarah Clark, MS CGC
• Debbie A. Clarke, PA

• Internal Medicine Physician in Stamford, CT
• Providers in Stamford, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.