DR. BRUCE E CLARK PH.D.
NPI 1669212395
Psychologist in St Louis Park, MN
About Dr. Bruce E Clark Ph.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. BRUCE E CLARK PH.D. (NPI 1669212395) is an individual psychologist in St Louis Park, Minnesota, licensed in Minnesota (LP7036) and active in the NPI registry since May 2024. He is enrolled in Medicare PECOS and maintains a secondary practice location in Robbinsdale.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Bruce E Clark Ph.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Bruce Clark reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
St Louis Park, MN 55416
- Reassigned Medicare billing, Minnesota enrollment
- 2,527 clinicians in this Medicare group
Forest Lake, MN 55025
- Reassigned Medicare billing, Minnesota enrollment
- 3 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
MINNEAPOLIS, MN 55416
ST LOUIS PARK, MN 55416
ST LOUIS PARK, MN 55416
ST LOUIS PARK, MN 55416
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 Bruce Clark's NPI number?
The NPI number for Bruce Clark is 1669212395. It was assigned to this individual provider in the NPPES registry on May 30, 2024.
Where is Bruce Clark located?
Bruce Clark practices at 3800 Park Nicollet Blvd, St Louis Park, MN 55416. The listed phone number is (952) 993-3123.
What is Bruce Clark's specialty?
The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.
Is Bruce Clark enrolled in Medicare?
Yes. Bruce Clark is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Bruce Clark's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Bruce Clark reassigns Medicare benefits to 2 organizations: Park Nicollet Clinic (St Louis Park, MN) and Mindful You Behavioral Health PLLC (Forest Lake, MN). Each 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 Bruce Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Bruce Clark accept?
Health plans from HealthPartners list Bruce Clark 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.
When was this NPI record last updated?
The NPPES record for Bruce Clark was last updated on August 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.