NPIMap

Individual provider Active NPI

Matthew H Clark, M.D.

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Newport Beach, CA
National Provider Identifier
1952417339
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
License
G85764 Issued in CA
Practice address
520 Superior Ave
Suite 225
Newport Beach, CA 92663-3637
Phone
(949) 360-0300
Fax
(949) 360-6932
NPI assigned
Aug 21, 2006
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X G85764 CA
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X G85764 CA Primary

Addresses

Primary practice location

520 Superior Ave
Suite 225
Newport Beach, CA 92663-3637

Mailing address

520 Superior Ave
Suite 225
Newport Beach, CA 92663-3637
Phone (949) 360-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20061122000510 CA Practitioner - Obstetrics/GynecologyPractitioner - Urology 4587662788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/GynecologyAlso: Urology
Education
University of Utah School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

520 Superior Ave
Suite 225
Newport Beach, CA 92663-3637

520 Superior Ave
Suite 225
Newport Beach, CA 92663-3667
Phone (949) 360-0300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G85764CAMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew Houston Clark MD Inc Urogynecology and Reconstructive Pelvic Surgery CurrentSince Mar 25, 2010 Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients

Locations

16305 Sand Canyon Ave
Ste 220
Irvine, CA 92618
Phone (909) 558-2840

520 Superior Ave
Ste 225
Newport Beach, CA 92663
Phone (949) 360-0300

520 Superior Ave
Ste 205
Newport Beach, CA 92663
Phone (949) 650-2462

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: drmatthewhclark@theclarkcenter.ssdirect.aprima.com

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1952417339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 SUPERIOR AVE",
            "address_2": "SUITE 225",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633637",
            "telephone_number": "949-360-0300",
            "fax_number": "949-360-6932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 SUPERIOR AVE",
            "address_2": "SUITE 225",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633637",
            "telephone_number": "949-360-0300",
            "fax_number": "949-360-6932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MATTHEW",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": "G85764",
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "CA",
            "license": "G85764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.