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DR. STEVAN RAY CLARK M.D.
NPI 1376616227
Specialist in Los Angeles, CA

Active since November 16, 2006PECOS EnrolledAccepts Medicare Assignment
10220 S WESTERN AVE, LOS ANGELES, CA 90047(323) 757-1744(323) 757-3818 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Stevan Ray Clark M.d. NPPES

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

DR. STEVAN RAY CLARK M.D. (NPI 1376616227) is an individual specialist in Los Angeles, California, licensed in California (G63102) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS and is a graduate of University Of California, Geffen School Of Medicine (1985).

NPPES Registry Identity

NPI1376616227
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameDR. STEVAN RAY CLARKCredential: M.D.
Location Address10220 S WESTERN AVELos Angeles, CA 90047-4258
Mailing Address10220 S Western AveLos Angeles, CA 90047-4258 · (323) 757-1744 · Fax (323) 757-3818
Phone(323) 757-1744
Fax(323) 757-3818
Sole ProprietorYes
Medical School CMSUniversity Of California, Geffen School Of MedicineGraduated 1985
Enumeration DateNovember 16, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1376616227 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in CA · G63102
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
10220 S WESTERN AVE, Los Angeles, CA 90047
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Other Identifiers 3

Medicare UPINF03330CA
Medicaid00G631020CA
Medicare ID-Type UnspecifiedSCG63102CA

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. Stevan Ray Clark M.d. 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 ID5698899268
PECOS Enrollment IDI20100903000023
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

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
53 services27 patients

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 Stevan Clark's NPI number?

The NPI number for Stevan Clark is 1376616227. It was assigned to this individual provider in the NPPES registry on November 16, 2006.

Where is Stevan Clark located?

Stevan Clark practices at 10220 S Western Ave, Los Angeles, CA 90047. The listed phone number is (323) 757-1744.

What is Stevan Clark's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Stevan Clark enrolled in Medicare?

Yes. Stevan Clark 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.

When was this NPI record last updated?

The NPPES record for Stevan Clark was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.