DR. BRADLEY C CLARK MD
NPI 1316107642
Pediatrics - Pediatric Cardiology in Bronx, NY

Q: What is Bradley Clark's NPI number?

The NPI number for Bradley Clark is 1316107642. It was assigned to this individual provider in the NPPES registry on June 10, 2008.

Q: What is Bradley Clark's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Cardiology, with taxonomy code 2080P0202X.

Q: When was this NPI record last updated?

The NPPES record for Bradley Clark was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 10, 2008PECOS EnrolledAccepts Medicare Assignment

3415 BAINBRIDGE AVE, BRONX, NY 10467(718) 741-2183 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 17, 2018, Jan 12, 2018 (2 updates tracked since 2018).

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About Dr. Bradley C Clark Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BRADLEY C CLARK MD (NPI 1316107642) is an individual pediatric cardiology provider in Bronx, New York, licensed in New York (261152) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS, maintains a secondary practice location in Washington, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1316107642

Entity TypeIndividualMale

Primary Taxonomy2080P0202X

Provider Legal NameDR. BRADLEY C CLARKCredential: MD

Location Address3415 BAINBRIDGE AVEBronx, NY 10467-2403

Mailing Address3415 Bainbridge AveBronx, NY 10467-2403 · (718) 741-2183

Phone(718) 741-2183

Sole ProprietorNo

Medical School CMSOtherGraduated 2008

Enumeration DateJune 10, 2008

Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration

✔ NPI 1316107642 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric CardiologyAllopathic & Osteopathic Physicians

Taxonomy Code2080P0202X

License✔ Licensed in NY · 261152

Definition

A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

3415 BAINBRIDGE AVE, Bronx, NY 10467

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Secondary Practice Location 1

Location 1111 Michigan Ave NW, W3.5, 600Washington, DC 20010-2916 · Phone (202) 476-3670

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Medica, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Bradley C Clark Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6305007451

PECOS Enrollment IDI20221018000568

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. ASHLEY RAE NOBOA MSN, FNP-C

Nurse Practitioner (Family)