Matthew Lewis Clark, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

4301500350 Issued in MI

Practice address

1000 W University Dr Ste 314
Rochester, MI 48307-1876

Phone

(248) 375-4033

Fax

(248) 375-4034

NPI assigned

Jun 26, 2015

Last updated

Feb 22, 2025By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Dermatology

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Modern Dermatology PLLCGroup PAC ID 7113335951, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.8 of 100Reported as group

Promoting interoperability

88

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mclark1121322@direct.hfhs.org

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.

• Modern Dermatology, PLLC

  • Dermatology Physician
  • Rochester, MI
  • NPI 1750967691
  Medicare reassignment Care Compare group NPD
• Pinnacle Dermatology, SC

  • Dermatology Physician
  • Joliet, IL
  • NPI 1861930984

  MI

  Medicare reassignment
• Alan Bolton, MD, PC

  • Obstetrics & Gynecology Physician
  • Berkley, MI
  • NPI 1467632901
  NPD
• Audrey Bruell, M.D. P.C.

  • Dermatology Physician
  • Livonia, MI
  • NPI 1306965983
  NPD
• Floyd County Memorial Hospital Commission

  • Critical Access Hospital
  • Charles City, IA
  • NPI 1265402390
  NPD (past)

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

{
    "created_epoch": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740182400000",
    "number": "1902288806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W UNIVERSITY DR STE 314",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071876",
            "telephone_number": "245-375-4033",
            "fax_number": "248-375-4034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W UNIVERSITY DR STE 314",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071876",
            "telephone_number": "248-375-4033",
            "fax_number": "248-375-4034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MATTHEW",
        "middle_name": "LEWIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-26",
        "last_updated": "2025-02-22",
        "certification_date": "2025-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301108372",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301500350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Anthony Cicala, D.C.
• City of Rochester (Rochester Fire Department)
• Amy M Clapp, MPT
• Debra Striler Clark, M.A., PSY.S, L.L.P.
• Jon B Clark, PHD
• Nicole Renee Clark, NP
• Amy Elizabeth Cleland, MPT
• Matthew Sean Akira Clifford, M.D.
• Erica Cogswell
• Carolynne Coleman, RN

• Dermatology Physician in Rochester, MI
• Providers in Rochester, MI by specialty
• Dermatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.
• 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.