NPIMap

Individual provider Active NPI

Clifford D Clark, M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Fort Collins, CO
National Provider Identifier
1881612653
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
DR.0047585 Issued in CO
Practice address
2500 E Prospect Rd
Fort Collins, CO 80525-9718
Phone
(970) 493-0112
NPI assigned
Jul 18, 2006
Last updated
Dec 16, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X DR.0047585 CO Primary

Addresses

Primary practice location

2500 E Prospect Rd
Fort Collins, CO 80525-9718

Mailing address

2500 E Prospect Rd
Fort Collins, CO 80525-9718
Phone (970) 439-0112

Other identifiers 3

IdentifierTypeStateIssuer
12688200MedicaidWY
P00755984OtherCORR MEDICARE
66729378MedicaidCO

Other names 1

  • Clifford D Clark Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090723000717 CO Practitioner - Orthopedic Surgery 6800960618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of New Mexico School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Physical Therapy of West Denver Limited PartnershipGroup PAC ID 6709771157, shared by 5 NPIs, 530 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

1024 S Lemay
Poudre Valley Hospital
Fort Collins, CO 80524-3929
Phone (970) 493-0112

1610 Dry Creek Dr
Longmont, CO 80503-6405
Phone (303) 772-1600

1926 61St Ave
Greeley, CO 80634-8165
Phone (970) 573-3224

2420 E Prospect Rd
Fort Collins MRI
Fort Collins, CO 80525-9718
Phone (970) 493-0567

2500 E Prospect Rd
Fort Collins, CO 80525-9718
Phone (970) 493-4010

2964 Ginnala Dr
Loveland, CO 80538-2701
Phone (970) 667-7755

3470 E 15TH St
Loveland, CO 80538-8809
Phone (970) 292-1900

730 14TH St SW
Loveland, CO 80537-6349
Phone (970) 663-0815

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.72 of 100Reported as group
Quality
70.39
Promoting interoperability
71
Improvement activities
40
Cost
69.52

Merit-based Incentive Payment System (MIPS)

Final score
86.12 of 100Reported as group
Quality
74.76
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement199
Knee replacement162
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0047585COMDAdult Reconstructive Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic & Spine Center of the Rockies PC Orthopaedic Surgery CurrentSince Aug 1, 2009 Accepting new patients
University of Utah Orthopedic Consultants Orthopaedic Surgery Past Accepting new patients

Locations

2500 E Prospect Rd
Fort Collins, CO 80525
Phone (800) 722-7441

1926 61st Ave
Greeley, CO 80634
Phone (970) 573-3224

3470 E 15th St
Loveland, CO 80538
Phone (970) 663-3975

Organizations & group practices 2

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.

Hospital & facility affiliations 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1881612653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 E PROSPECT RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805259718",
            "telephone_number": "970-439-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E PROSPECT RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805259718",
            "telephone_number": "970-493-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CLIFFORD",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "CO",
            "license": "DR.0047585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12688200",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00755984",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "66729378",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLIFFORD",
            "last_name": "CLARK",
            "middle_name": "D",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.