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DR. EDWARD C CLARK M.D. NPI 1013917814


NPI Information

NPI: 1013917814
Provider Name: DR. EDWARD C CLARK, M.D.
Classification: Internal Medicine - 207RN0300X
Entity Type: Individual

Specialization: Nephrology

PECOS Registration: Yes

Address:
311 W 24TH ST
SUITE 402
ERIE, PA
ZIP 16502
Phone: (814) 453-6687
Get Directions

DR. Edward C Clark, M.D. is a nephrology internal medicine in Erie, PA with 41 years of experience. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. DR. Edward C Clark, M.D. NPI is 1013917814. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: HAHNEMANN UNIVERSITY COLLEGE OF MEDICINE
Graduation Year:1983

The provider's business location address is:

311 W 24TH ST
SUITE 402
ERIE, PA
ZIP 16502-665
Phone: (814) 453-6687
Fax: (814) 456-4676

The NPI 1013917814 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Dialysis services (4 or more physician visits per month), patient 20 years of age and older (HCPCS:90960)
  • Dialysis services (2-3 physician visits per month), patient 20 years of age and older (HCPCS:90961)
  • Hemodialysis procedure with one physician evaluation (HCPCS:90935)
  • Dialysis services (1 physician visit per month), patient 20 years of age and older (HCPCS:90962)

The enumeration date for this NPI number is 7/22/2005 and was last updated on 11/13/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RN0300XInternal MedicineNephrologyMD055901LPENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10015345390001MEDICAIDPENNSYLVANIA
2776463MEDICARE PINPENNSYLVANIA
3776463MEDICARE ID-TYPE UNSPECIFIEDPENNSYLVANIA
4E41586MEDICARE UPINPUERTO RICO
5776463OTHERPENNSYLVANIAHIGHMARK PA BS
6390004949OTHERPENNSYLVANIAMEDICARE PALMETTO
7208292OTHERPENNSYLVANIAUPMC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.