DR. GARY BRUCE CLARK MD
NPI 1902962939
General Practice in Boulder, CO
NPI Status: Active since December 27, 2006
Contact Information
1790 30TH ST
SUITE 230
BOULDER, CO
ZIP 80301
Phone: (303) 444-5131
Fax: (303) 444-5131
- Individual
- Male
- General Practice
- PECOS Enrolled
- Opted-Out Medicare
About GARY CLARK
This page provides the complete NPI Profile along with additional information for Gary Clark, a primary care provider established in Boulder, Colorado with a medical specialization in General Practice. The healthcare provider is registered in the NPI registry with number 1902962939 assigned on December 2006. The practitioner's primary taxonomy code is 208D00000X with license number 20926 (CO). The provider is registered as an individual and his NPI record was last updated 19 years ago.
- NPI
- 1902962939
- Provider Name
- DR. GARY BRUCE CLARK MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1790 30TH ST SUITE 230 BOULDER, CO 80301
- Location Phone
- (303) 444-5131
- Location Fax
- (303) 444-5131
- Mailing Address
- 12541 GROVE ST BROOMFIELD, CO 80020
- Mailing Phone
- (720) 887-5726
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 12-27-2006
- Last Update Date
- 07-08-2007
- Code Navigator
A primary care provider (PCP) like Gary Clark sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Gary Clark opted out of Medicare effective on 09-24-2015 until 09-24-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
General Practice
- Taxonomy Code
- 208D00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 20926
- License State
- CO
- Taxonomy Description
- A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Medicare Participation & PECOS Enrollment Status
Gary Clark is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 09-24-2015
Opt-Out End Date: 09-24-2027
Eligible to Order and Refer? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1902962939, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 71. The final step is to find the difference between that total and the next multiple of ten (80 - 71 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 71 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 17 providers are registered at the same or a nearby location.
BOULDER, CO 80301
BOULDER, CO 80301
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1902962939, enumerated as an "individual" on December 27, 2006.
The provider is located at 1790 30TH ST SUITE 230 BOULDER, CO 80301 and the phone number is (303) 444-5131.
General Practice with taxonomy code 208D00000X.
