Kenneth P Clark, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

NH0659 Issued in NH

Practice address

65 Rochester Hill Rd
Rochester, NH 03867-3231

Phone

(603) 332-8569

Fax

(603) 332-5546

NPI assigned

Jan 26, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rochester Eye Care Associates PLLCGroup PAC ID 6901980291, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

71.67 of 100Reported as individual

Quality

93.33

Improvement activities

20

Medicare enrollment (NPD)

Enrolled

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.

• Rochester Eye Care Associates PLLC

  • Optometrist
  • Rochester, NH
  • NPI 1770764821
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342742400000",
    "number": "1962472498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 ROCHESTER HILL RD",
            "city": "ROCHESTER",
            "state": "NH",
            "postal_code": "038673231",
            "telephone_number": "603-332-8569",
            "fax_number": "603-332-5546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 ROCHESTER HILL RD",
            "city": "ROCHESTER",
            "state": "NH",
            "postal_code": "038673231",
            "telephone_number": "603-332-8569",
            "fax_number": "603-332-5546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KENNETH",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2012-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NH",
            "license": "NH0659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30011388",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jane Chase, RN
• Laurie Chase, MS
• Terasa Chaurasia
• Jennifer Chesley, RN
• Herbert C. Clark, O.D.
• Michael T Clark, D. C.
• Kendra Cline, APRN
• Kendra E Cline, APRN
• Patricia Ann Clough, MS, LMFT
• Wendy Susan Clough, RPH

• Optometrist in Rochester, NH
• Providers in Rochester, NH by specialty
• Optometrist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; 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.