Active NPI
Alexander Richard Clarke, M.D.
- Psychiatry Physician
- Redwood City, CA
National Provider Identifier
1982091062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 143985
- Practice address
- 611 Veterans Blvd # 116
Redwood City, CA 94063-1499 - Phone
- (650) 382-2090
- NPI assigned
- Apr 16, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 143985 | CA | Primary |
Addresses
Primary practice location
611 Veterans Blvd # 116
Redwood City, CA 94063-1499
Mailing address
548 Market St Ste 74687
San Francisco, CA 94104-5401
Phone (650) 382-2090
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 7, 2020 through Oct 7, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 143985 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605571200000",
"number": "1982091062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "548 MARKET ST STE 74687",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941045401",
"telephone_number": "650-382-2090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 VETERANS BLVD # 116",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940631499",
"telephone_number": "650-382-2090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARKE",
"first_name": "ALEXANDER",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-04-16",
"last_updated": "2020-11-17",
"certification_date": "2020-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "143985",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redwood City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.