Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacob Tyler Clark, MD

Individual provider Emergency Medicine Physician · NPI 1437512613

Jacob Tyler Clark, MD is an Emergency Medicine in Green Bay, Wisconsin. Graduated from New York Medical College in 2016, 10 years ago. Practices with Baycare Aurora LLC, a 199-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
10
Trained at
New York Medical College
Licensed in
WI
In the registry since
2016
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone: (920) 288-4060
Fax: (920) 288-4067
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 6446-851 (WI)

Record details

NPI number1437512613
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 4, 2016
Last updated in NPPESApril 21, 2026
Certification dateApril 21, 2026
Mailing address1035 Kepler Dr, Green Bay, WI 54311-8320

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolNEW YORK MEDICAL COLLEGE
Graduated 2016 (10 years in practice)
Group practice Baycare Aurora Llc — 199 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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