BENNETT WILLIAM CLARK M.D.
NPI 1831416569
Internal Medicine in Stamford, CT

Active since April 20, 2010Opted out of Medicare · through Jun 9, 2027
9 W BROAD ST STE 320, STAMFORD, CT 06902(475) 251-8856 Get Directions Write a Review

NPPES record last updated: July 21, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Bennett William Clark M.d. NPPES

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

BENNETT WILLIAM CLARK M.D. (NPI 1831416569) is an individual internal medicine provider in Stamford, Connecticut, licensed in Minnesota (62233) and active in the NPI registry since April 2010. He has opted out of Medicare through June 9, 2027 and remains eligible to order and refer and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1831416569
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameBENNETT WILLIAM CLARKCredential: M.D.
Location Address9 W BROAD ST STE 320Stamford, CT 06902-3758
Mailing Address9 W Broad St Ste 320Stamford, CT 06902-3758
Sole ProprietorNo
Enumeration DateApril 20, 2010
Last NPPES UpdateJuly 21, 2025
NPPES CertifiedJuly 21, 2025
NPI 1831416569 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses Licensed in MN · 62233 Licensed in MD · D0075366
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedHospitalistTaxonomy 208M00000X · License 54459 (CT)
9 W BROAD ST STE 320, Stamford, CT 06902

Secondary Practice Locations 2

Location 12450 Riverside AveMinneapolis, MN 55454-1450 · Phone (612) 672-6000
Location 2600 N Wolfe St, NELSON 215Baltimore, MD 21287-0005 · Phone (410) 502-2128

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Bennett William Clark M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 9, 2025 through June 9, 2027.

Opt-Out Effective DateJune 9, 2025
Opt-Out In Effect ThroughJune 9, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06902 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
$138.84 typical visit price
range $60.82 – $183.10
Typical copayment $34.71 (range $15.20 – $45.77)
Most-billed visit code 99204
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
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.

Other Providers at the Same Location NPPES 3

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

Behavior Analyst
9 W BROAD ST STE 320
STAMFORD, CT 06902
General Practice
9 W BROAD ST STE 320
STAMFORD, CT 06902
Counselor (Professional)
9 W BROAD ST STE 320
STAMFORD, CT 06902

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 Bennett Clark's NPI number?

The NPI number for Bennett Clark is 1831416569. It was assigned to this individual provider in the NPPES registry on April 20, 2010.

Where is Bennett Clark located?

Bennett Clark practices at 9 W Broad St Ste 320, Stamford, CT 06902. The listed phone number is (475) 251-8856.

What is Bennett Clark's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Bennett Clark enrolled in Medicare?

No. Bennett Clark has opted out of Medicare through June 9, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Bennett Clark was last updated on July 21, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.