Charlotte M Clark, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

286912 Issued in NY

Practice address

400 Webster Ave
New Rochelle, NY 10801-3206

Phone

(718) 362-1411

Fax

(718) 414-1651

NPI assigned

May 21, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Charlotte Maria-Carlotta Clark Professional name

Medicare fee-for-service enrollment

Enrolled in NY

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.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Clark Medical Care, P.L.L.C.

  • Internal Medicine Physician
  • New Rochelle, NY
  • NPI 1952935702

  Single Specialty

  Medicare reassignment NPD Authorized official
• Dial Doc Now Medical Group PC

  • Family Medicine Physician
  • New York, NY
  • NPI 1386245702

  Single Specialty

  NPD

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

{
    "created_epoch": "1242864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525046400000",
    "number": "1891920682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 E ROUTE 59 # 408",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542905",
            "telephone_number": "718-362-1411",
            "fax_number": "718-414-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 WEBSTER AVE",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108013206",
            "telephone_number": "718-362-1411",
            "fax_number": "718-414-1651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHARLOTTE",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-21",
        "last_updated": "2018-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "286912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLOTTE",
            "last_name": "CLARK",
            "middle_name": "MARIA-CARLOTTA",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• City School District of New Rochelle
• City School District of New Rochelle
• City School District of New Rochelle
• Stephanie Clapes
• Clark Medical Care, P.L.L.C.
• Sonya Clark
• Claude Errington Williams, DPM, P.C.
• Deborah Anne Clelland, MPS
• Dominique Clery
• Clinical and Interventional Cardiology PLLC

• Internal Medicine Physician in New Rochelle, NY
• Providers in New Rochelle, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; 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.