1. Home
  2. Directory
  3. Georgia
  4. Atlanta
  5. Family Medicine
  6. NPI Profile

MARK A CLARK MD
NPI 1417061458
Family Medicine in Atlanta, GA

Active since August 18, 2006PECOS Enrolled
1745 PEACHTREE ST STE U, INTERNAL MEDICINE HEALTH CARE TEAM A, ATLANTA, GA 30309(404) 888-7646(404) 888-7647 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Mark A Clark Md NPPES

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

MARK A CLARK MD (NPI 1417061458) is an individual family medicine provider in Atlanta, Georgia, licensed in Georgia (042805) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417061458
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameMARK A CLARKCredential: MD
Location Address1745 PEACHTREE ST STE U, INTERNAL MEDICINE HEALTH CARE TEAM AAtlanta, GA 30309
Mailing Address3495 Piedmont Rd Ne, Nine Piedmont CenterAtlanta, GA 30305-1736 · (404) 364-7000
Phone(404) 888-7646
Fax(404) 888-7647
Sole ProprietorNo
Enumeration DateAugust 18, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1417061458 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in GA · 042805
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1745 PEACHTREE ST STE U, Atlanta, GA 30309
Open in Google Maps ↗

Other Identifiers 2

Medicare UPIND17648
Medicare ID-Type Unspecified08BBRNP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mark A Clark Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Mark Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

The Southeast Permanente Medical Group
3.7 mi
Internal Medicine
3495 PIEDMONT ROAD NE, NINE PIEDMONT CENTER
Atlanta, GA 30305
  • Reassigned Medicare billing, Georgia enrollment
  • 1,389 clinicians in this Medicare group
NPI 1245266956 (404) 364-3821

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30309 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Mark Clark's NPI number?

The NPI number for Mark Clark is 1417061458. It was assigned to this individual provider in the NPPES registry on August 18, 2006.

Where is Mark Clark located?

Mark Clark practices at 1745 Peachtree St Ste U Internal Medicine Health Care Team A, Atlanta, GA 30309. The listed phone number is (404) 888-7646.

What is Mark Clark's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Mark Clark enrolled in Medicare?

Yes. Mark Clark is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mark Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mark Clark reassigns Medicare benefits to The Southeast Permanente Medical Group (Atlanta, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mark Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mark 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.