Individual provider Active NPI

Margaret E. Clark, NP

  • Nurse Practitioner
  • Royal Oak, MI
National Provider Identifier
1972977247
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704267676 Issued in MI
Practice address
3535 W 13 Mile Rd
Ste. 248
Royal Oak, MI 48073-6770
Phone
(248) 551-1515
Fax
(248) 551-1516
NPI assigned
Nov 24, 2015
Last updated
Oct 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704267676 MI Primary

Addresses

Primary practice location

3535 W 13 Mile Rd
Ste. 248
Royal Oak, MI 48073-6770

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mclark24052@direct.beaumont.edu

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151209000752 MI Practitioner - Nurse Practitioner 5799086120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

28100 Grand River Ave
Farmington Hills, MI 48336-5970

3535 W 13 Mile Rd
Royal Oak, MI 48073-6770

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.37 of 100Reported as group
Quality
66.73
Promoting interoperability
100
Improvement activities
40
Cost
70.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704267676MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont Medical Group- Specialty Services CurrentSince Oct 1, 2018 Accepting new patients

Locations

28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320

468 Cadieux Rd
Grosse Pointe Woods, MI 48230
Phone (313) 343-1000

3535 W 13 Mile Rd
Royal Oak, MI 48073
Phone (248) 551-1010

3535 W 13 Mile Rd
Ste 248
Royal Oak, MI 48073
Phone (248) 551-1515

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

29355 Northwestern Hwy
Ste 210
Southfield, MI 48034
Phone (248) 356-7726

Interoperability endpoints

  • Direct secure messaging: mclark1229028@epic00.shdirect.org
  • Direct secure messaging: mclark24052@direct.beaumont.edu

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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": "1448323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1972977247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 W 13 MILE RD",
            "address_2": "STE. 248",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736770",
            "telephone_number": "248-551-1515",
            "fax_number": "248-551-1516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MARGARET",
        "middle_name": "E.",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-24",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704267676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mclark24052@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "3535 W 13 Mile Rd",
            "address_2": "Ste. 248",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480736770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.