MS. SHERYL DIANE CLARK MD
NPI 1508963422
Dermatology in New York, NY
NPI Status: Active since September 20, 2006
Contact Information
109 E 61 ST
NEW YORK, NY
ZIP 10021
Phone: (212) 750-2905
Fax: (212) 888-0930
- Individual
- Female
- Years of Experience 44
- Dermatology
- May Accept Medicare Approved Payment
- Opted-Out Medicare
- CLIA Number: 33D0673142
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 07-18-2025
About SHERYL CLARK
This page provides the complete NPI Profile along with additional information for Sheryl Clark, a provider established in New York, New York with a medical specialization in Dermatology and more than 44 years of experience. She graduated from Clvlnd Clinic Lerner College Of Med Of Case Wstn Rsv University in 1982. The healthcare provider is registered in the NPI registry with number 1508963422 assigned on September 2006. The practitioner's primary taxonomy code is 207N00000X with license number 176093 (NY). The provider is registered as an individual and her NPI record was last updated 18 years ago.
- NPI
- 1508963422
- Provider Name
- MS. SHERYL DIANE CLARK MD
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 109 E 61 ST NEW YORK, NY 10021
- Location Phone
- (212) 750-2905
- Location Fax
- (212) 888-0930
- Mailing Address
- 109 E 61 ST NEW YORK, NY 10021
- Mailing Phone
- (212) 750-2905
- Mailing Fax
- (212) 888-0930
- Medical School Name
- CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
- Graduation Year
- 1982
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-20-2006
- Last Update Date
- 07-08-2007
- Code Navigator
A dermatologist like Sheryl Clark is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.
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. Sheryl Clark opted out of Medicare effective on 01-01-2025 until 01-01-2027. 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 and cannot 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
Dermatology
- Taxonomy Code
- 207N00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 176093
- License State
- NY
- Taxonomy Description
- A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Medicare Participation & PECOS Enrollment Status
Sheryl Clark is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.
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.
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 01-01-2025
Opt-Out End Date: 01-01-2027
Eligible to Order and Refer? No
PECOS PAC ID: 8123295821
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20120120000491
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Maybe
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Biopsy of related skin growth, first growth
Destruction of precancer skin growth, 1 growth
Destruction of skin growth, 1-14 growths
Established patient office or other outpatient visit, 10-19 minutes
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Melanoma (skin cancer) excision
New patient office or other outpatient visit, 30-44 minutes
A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.
This service was performed 20 times for 15 patients"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.
This service was performed 22 times for 18 patients"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.
This service was performed 26 times for 20 patientsThis is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
This service was performed 30 times for 23 patientsThis is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 74 times for 62 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 28 times for 23 patientsMelanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.
This service was performed for 1-10 patientsThis service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
This service was performed 12 times for 12 patientsCLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 33D0673142
- Facility Type
- Physician Office
- Certificate Effective Date
- July 19, 2023
- Certificate Expiration Date
- July 18, 2025
- Laboratory Director
- DR. SHERYL CLARK
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Sheryl Clark to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
1 | 5 | 0 | 8 | 9 | 6 | 3 | 4 | 2 | 2 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 5 | 0 | 8 | 18 | 6 | 6 | 4 | 4 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 5 + 0 + 8 + 1 + 8 + 6 + 6 + 4 + 4 + 24 = 68 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
70 - 68 = 2 | 2 |
The NPI number 1508963422 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1508963422, enumerated in the NPI registry as an "individual" on September 20, 2006
The provider is located at 109 E 61 St New York, Ny 10021 and the phone number is (212) 750-2905
The provider's speciality is Dermatology with taxonomy code 207N00000X
The provider has more than 44 years of experience. She graduated from Clvlnd Clinic Lerner College Of Med Of Case Wstn Rsv University in 1982.
The most common procedures or services performed by this practitioner are: Biopsy of related skin growth, first growth, Destruction of precancer skin growth, 1 growth, Destruction of skin growth, 1-14 growths, Established patient office or other outpatient visit, 10-19 minutes, Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes, Melanoma (skin cancer) excision and New patient office or other outpatient visit, 30-44 minutes.
The provider's CLIA number is 33D0673142 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
No, the provider signed an affidavit on January 01, 2025 to opt-out of the Medicare program. The provider is excluded from the Medicare program until January 01, 2027.
This NPI record was last updated on September 20, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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