Clinton David Protack, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

D87273 Issued in MD

Practice address

520 Upper Chesapeake Dr Ste 306
Bel Air, MD 21014-4375

Phone

(410) 879-2006

Fax

(410) 879-0428

NPI assigned

Jul 1, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Vascular Surgery

Education

University of Rochester School of Medicine and Dentistry, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vascular Surgery Associates LLCGroup PAC ID 3173500410, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Greater Baltimore Medical Center Hospital, Baltimore, MD, CCN 210044
• University of MD St Joseph Medical Center Hospital, Towson, MD, CCN 210063
• Umd Upper Chesapeake Medical Center Hospital, Bel Air, MD, CCN 210049
• Sinai Hospital of Baltimore Hospital, Baltimore, MD, CCN 210012

Merit-based Incentive Payment System (MIPS)

Final score

85.84 of 100Reported as group

Quality

73.85

Promoting interoperability

88

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: clinton.protack.p1@direct.vsadocs.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: cprotack641193@direct.umm.edu

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.

• Vascular Surgery Associates, L.L.C.

  • Vascular Surgery Physician
  • Bel Air, MD
  • NPI 1548222912
  Medicare reassignment Care Compare group NPD
• Vascular Surgery Associates, L.L.C.

  • Durable Medical Equipment & Medical Supplies
  • Westminster, MD
  • NPI 1174234827
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

• Greater Baltimore Medical Center, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1255372397
  Care Compare affiliation
• Sinai Hospital of Baltimore, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1285672204
  Care Compare affiliation
• Sinai Hospital of Baltimore, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1487325874
  Care Compare affiliation
• University of Maryland St. Joseph Medical Center, LLC

  • General Acute Care Hospital
  • Towson, MD
  • NPI 1124374079
  Care Compare affiliation
• Upper Chesapeake Medical Center, Inc.

  • General Acute Care Hospital
  • Bel Air, MD
  • NPI 1598761355
  Care Compare affiliation

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1952563801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 UPPER CHESAPEAKE DR STE 306",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144375",
            "telephone_number": "410-879-2006",
            "fax_number": "410-879-0428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 UPPER CHESAPEAKE DR STE 306",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144375",
            "telephone_number": "410-879-2006",
            "fax_number": "410-879-0428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROTACK",
        "first_name": "CLINTON",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-01",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MD",
            "license": "D87273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leonard R Proctor, M.D.
• Professional Dental Associates LLC
• Professional Vision of Bel Air Inc
• Progressive Physical Therapy, LLC
• Erin Prokop, C.F.N.P.
• Lisa Proutt, PT
• Lindsey Provelengios, LCPC
• Jacklyn Marie Puopolo
• Elizabeth L Purdum, LMSW
• Peter Joseph Purol

• Vascular Surgery Physician in Bel Air, MD
• Providers in Bel Air, MD by specialty
• Vascular Surgery Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; 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.