NISSE VIRGINIA CLARK M.D.
NPI 1982967105
Obstetrics & Gynecology - Gynecology in Boston, MA

Active since June 21, 2012PECOS EnrolledAccepts Medicare Assignment

NPPES record last updated: April 11, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Nisse Virginia Clark M.d. NPPES

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

NISSE VIRGINIA CLARK M.D. (NPI 1982967105) is an individual gynecology provider in Boston, Massachusetts, licensed in Massachusetts (265956) and active in the NPI registry since June 2012. She is enrolled in Medicare PECOS, is affiliated with Emerson Hospital -, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1982967105
Entity TypeIndividualFemale
Primary Taxonomy207VG0400X
Provider Legal NameNISSE VIRGINIA CLARKCredential: M.D.
Location Address55 FRUIT STBoston, MA 02114-2621
Mailing Address800 Washington StBoston, MA 02111-1552 · (617) 636-5000
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateJune 21, 2012
Last NPPES UpdateApril 11, 2018
NPI 1982967105 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyObstetrics & Gynecology · GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207VG0400X
License Licensed in MA · 265956
Definition
A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee
Also ListedObstetrics & GynecologyTaxonomy 207V00000X · License 252130 (MA)
55 FRUIT ST, Boston, MA 02114

Secondary Practice Locations 2

Location 155 Fruit St # 4Boston, MA 02114-2621 · Phone (617) 724-6850
Location 2800 Washington StBoston, MA 02111-1552 · Phone (617) 636-5000

Accepted Insurance

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

Nisse Virginia 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 ID8325337272
PECOS Enrollment IDI20170724002860
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Emerson Hospital -

Acute Care Hospitals · W Concord, MA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220084
Location133 Old Road To 9 Acre CornerW Concord, MA 01742 · Middlesex County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02114 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
$144.11 typical visit price
range $63.72 – $189.86
Typical copayment $36.02 (range $15.93 – $47.46)
Most-billed visit code 99204
Established Patient
$78.84 typical visit price
range $21.07 – $155.29
Typical copayment $19.71 (range $5.26 – $38.82)
Most-billed visit code 99213
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 20

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

Pathology (Anatomic Pathology)
55 FRUIT ST
BOSTON, MA 02114
Internal Medicine (Hematology & Oncology)
55 FRUIT ST
BOSTON, MA 02114
Anesthesiology
55 FRUIT ST, GRAY-BIGELOW 444
BOSTON, MA 02114
Physical Medicine & Rehabilitation
55 FRUIT ST
BOSTON, MA 02114
Internal Medicine (Infectious Disease)
55 FRUIT ST, DIVISION OF INFECTIOUS DISEASE, GRJ-504
BOSTON, MA 02114
Nurse Practitioner (Acute Care)
55 FRUIT ST, BIGALOW 852 F
BOSTON, MA 02114
Nurse Practitioner
55 FRUIT ST
BOSTON, MA 02114
Internal Medicine (Cardiovascular Disease)
55 FRUIT ST
BOSTON, MA 02114

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 Nisse Clark's NPI number?

The NPI number for Nisse Clark is 1982967105. It was assigned to this individual provider in the NPPES registry on June 21, 2012.

Where is Nisse Clark located?

Nisse Clark practices at 55 Fruit St, Boston, MA 02114. The listed phone number is (617) 724-6850.

What is Nisse Clark's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Gynecology, with taxonomy code 207VG0400X.

Is Nisse Clark enrolled in Medicare?

Yes. Nisse 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.

What insurance does Nisse Clark accept?

Health plans from Anthem Blue Cross and Blue Shield list Nisse 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.

Is Nisse Clark affiliated with any hospitals?

According to CMS data, Nisse Clark is affiliated with Emerson Hospital -.

When was this NPI record last updated?

The NPPES record for Nisse Clark was last updated on April 11, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.