Michelle W Clark, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0008552 Issued in CO

Practice address

1275 York Ave
New York, NY 10065-6007

Phone

(212) 639-2000

NPI assigned

Feb 11, 2020

Sex

Female

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, CO2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial Anesthesiology GroupGroup PAC ID 8729977129, 298 clinicians

Rocky Mountain Cancer Centers LLPGroup PAC ID 7012820533, 131 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centura Health-St Anthony Hospital Hospital, Lakewood, CO, CCN 060015
• Intermountain Health Lutheran Hospital Hospital, Wheat Ridge, CO, CCN 060009

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: mclark24709@mskcc.direct-ci.com
• Direct secure messaging: michelle.clark.1@19222.direct.athenahealth.com
• Direct secure messaging: michelle.clark@rmcc.ikm.direct-ci.com

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.

• Rocky Mountain Cancer Centers LLP

  • Hematology & Oncology Physician
  • Greenwood Village, CO
  • NPI 1518941186

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Memorial Anesthesiology Group

  • Anesthesiology Physician
  • New York, NY
  • NPI 1467423020
  Medicare reassignment Care Compare group
• Memorial Hematology Lymphoma Group

  • Hematology & Oncology Physician
  • New York, NY
  • NPI 1891766366
  Medicare reassignment
• Rocky Mountain Cancer Centers, LLP

  • Hematology & Oncology Physician
  • Longmont, CO
  • NPI 1538762760
  NPD

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

• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Lakewood, CO
  • NPI 1104466630
  Care Compare affiliation
• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Lakewood, CO
  • NPI 1164430567
  Care Compare affiliation
• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Lakewood, CO
  • NPI 1740820273
  Care Compare affiliation
• Catholic Health Initiatives Colorado

  • Air Ambulance
  • Lakewood, CO
  • NPI 1992425854

  Hospital

  Care Compare affiliation
• Intermountain Front Range, Inc

  • General Acute Care Hospital
  • Wheat Ridge, CO
  • NPI 1811739923
  Care Compare affiliation
• Intermountain Front Range, Inc.

  • General Acute Care Hospital
  • Golden, CO
  • NPI 1235803917
  Care Compare affiliation
• Intermountain Front Range, Inc.

  • General Acute Care Hospital
  • Wheat Ridge, CO
  • NPI 1619706249
  Care Compare affiliation
• Intermountain Front Range, Inc.

  • General Acute Care Hospital
  • Wheat Ridge, CO
  • NPI 1669461281
  Care Compare affiliation
• Intermountain Front Range, Inc.

  • General Acute Care Hospital
  • Golden, CO
  • NPI 1891576716
  Care Compare affiliation

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

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1881226462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5464 BULL CREEK DR",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430166178",
            "telephone_number": "440-320-2597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MICHELLE",
        "middle_name": "W",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-11",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0008552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison R Clark, NP
• Mark Clark, MD
• Mary K. Clark, NP
• Mary Marshall Clark, MASTER'S OF DIVINITY
• Michelle Clark, MD
• Nicholas Caleb Clark, MD
• Rachel Ann Clark
• Rebecca Clark
• Rebecca (Becky) A Clark, PHD, LCSW-R, CC-AASP
• Roger Clark

• Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.

Verify at the official NPI Registry.