Active NPI
Clarence Mast, MD
- Family Medicine Physician
- Meshoppen, PA
National Provider Identifier
1902898638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD 0126030E
- Practice address
- Route 6
Meshoppen, PA 18630 - Phone
- (570) 833-8300
- Fax
- (570) 833-8310
- NPI assigned
- Aug 18, 2005
- Last updated
- Mar 8, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD 0126030E | PA | Primary |
Addresses
Primary practice location
Route 6
Meshoppen, PA 18630
Mailing address
RR 1 Box 3J
Hospital Dr
Towanda, PA 18848-9706
Phone (570) 265-6300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 677564 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD 0126030E | PA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268006400000",
"number": "1902898638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "RR 1 BOX 3J",
"address_2": "HOSPITAL DR",
"city": "TOWANDA",
"state": "PA",
"postal_code": "188489706",
"telephone_number": "570-265-6300",
"fax_number": "570-268-2807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ROUTE 6",
"city": "MESHOPPEN",
"state": "PA",
"postal_code": "18630",
"telephone_number": "570-833-8300",
"fax_number": "570-833-8310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAST",
"first_name": "CLARENCE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-18",
"last_updated": "2010-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "MD 0126030E",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "677564",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Meshoppen, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.