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BRIAN CLARKE MD
NPI 1366804536
Surgery - Surgical Critical Care in Edgewood, KY

Active since March 25, 2016PECOS EnrolledAccepts Medicare Assignment
90.38/100
CMS Quality Rating
20 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017(859) 578-5880(859) 578-5881 Get Directions Write a Review

NPPES record last updated: November 21, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 21, 2024, Mar 7, 2023, Oct 11, 2022 and 2 more (5 updates tracked since 2016).

About Brian Clarke Md NPPES

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

BRIAN CLARKE MD (NPI 1366804536) is an individual surgical critical care provider in Edgewood, Kentucky, licensed in Kentucky (57309) and active in the NPI registry since March 2016. He is enrolled in Medicare PECOS, is affiliated with St Elizabeth Edgewood, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1366804536
Entity TypeIndividualMale
Primary Taxonomy2086S0102X
Provider Legal NameBRIAN CLARKECredential: MD
Location Address20 MEDICAL VILLAGE DREdgewood, KY 41017-5401
Mailing AddressPo Box 635283Cincinnati, OH 45263-5283 · (859) 578-5880 · Fax (859) 578-5881
Phone(859) 578-5880
Fax(859) 578-5881
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateMarch 25, 2016
Last NPPES UpdateNovember 21, 20245 updates tracked since enumeration
NPPES CertifiedNovember 21, 2024
✔ NPI 1366804536 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Surgical Critical CareAllopathic & Osteopathic Physicians
Taxonomy Code2086S0102X
License✔ Licensed in KY · 57309
Definition
A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
20 MEDICAL VILLAGE DR, Edgewood, KY 41017
Open in Google Maps ↗

Other Identifiers 2

Other21718HI · Medical License
Other57309KY · Medical License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.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

Brian Clarke 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 ID1951674209
PECOS Enrollment IDI20220930001714
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.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
151 services92 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
87 services57 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
47 services47 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
32 services22 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
31 services28 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
16 services15 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Elizabeth Edgewood

Acute Care Hospitals · Edgewood, KY
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number180035
Location1 Medical Village DriveEdgewood, KY 41017 · Kenton County
Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

90.38/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.76
Promoting Interoperability100
Improvement Activities40

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.

INFECTIOUS DISEASE CONSULTANTS INC
Internal Medicine (Infectious Disease)
20 MEDICAL VILLAGE DR, SUITE 355
EDGEWOOD, KY 41017
Kenton County (859) 344-1512
DAVID THOMAS TACKETT APRN
Nurse Practitioner
20 MEDICAL VILLAGE DR
EDGEWOOD, KY 41017
Kenton County (859) 578-5880
DEBORAH JOY BARNETT PA-C
Physician Assistant
20 MEDICAL VILLAGE DR
EDGEWOOD, KY 41017
Kenton County (859) 578-5880
VINCENT E ZIEGLER, PSC
Psychiatry & Neurology (Psychiatry)
20 MEDICAL VILLAGE DR, SUITE 301
EDGEWOOD, KY 41017
Kenton County (859) 341-5074
DR. MICHEAL LINK ROBINSON MD, DMD
Dentist (Oral and Maxillofacial Surgery)
20 MEDICAL VILLAGE DR, SUITE 196
EDGEWOOD, KY 41017
Kenton County (859) 331-2100
VIDYA RAJARAM DEVARAJAN M.D.
Internal Medicine (Infectious Disease)
20 MEDICAL VILLAGE DR
EDGEWOOD, KY 41017
Kenton County (859) 344-1512
THE CRANLEY SURGICAL ASSOC,INC.
Surgery
20 MEDICAL VILLAGE DR, SUITE 394
EDGEWOOD, KY 41017
Kenton County (859) 578-0442
ANNA MORIAH GROTE CRNA
Nurse Anesthetist, Certified Registered
20 MEDICAL VILLAGE DR
EDGEWOOD, KY 41017
Kenton County (859) 341-7246

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brian Clarke's NPI number?

The NPI number for Brian Clarke is 1366804536. It was assigned to this individual provider in the NPPES registry on March 25, 2016.

Where is Brian Clarke located?

Brian Clarke practices at 20 Medical Village Dr, Edgewood, KY 41017. The listed phone number is (859) 578-5880.

What is Brian Clarke's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Surgical Critical Care, with taxonomy code 2086S0102X.

Is Brian Clarke enrolled in Medicare?

Yes. Brian Clarke is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Brian Clarke accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and CareSource list Brian Clarke as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Brian Clarke affiliated with any hospitals?

According to CMS data, Brian Clarke is affiliated with St Elizabeth Edgewood.

When was this NPI record last updated?

The NPPES record for Brian Clarke was last updated on November 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.