Individual provider Active NPI

Jennifer L Clark, PA-C

  • Surgical Physician Assistant
  • Wexford, PA
National Provider Identifier
1013988401
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
MA051788 Issued in PA
Practice address
7500 Brooktree Rd
Wexford, PA 15090-9254
Phone
(412) 367-0600
NPI assigned
Feb 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X MA051788 PA Primary

Addresses

Primary practice location

7500 Brooktree Rd
Wexford, PA 15090-9254

Mailing address

7500 Brooktree Rd
Wexford, PA 15090-9254
Phone (412) 367-0600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040916000981 PA Practitioner - Physician Assistant 7012984180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upmc Multispecialty Group IncGroup PAC ID 7315263621, 57 clinicians

Practice addresses (Care Compare)

6998 Crider Rd
Suite 110
Mars, PA 16046-2390
Phone (866) 874-7483

9104 Babcock Blvd
Suite 2120
Pittsburgh, PA 15237-5818
Phone (866) 874-7483

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.85 of 100Reported as group
Quality
69.17
Promoting interoperability
100
Improvement activities
40
Cost
77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA051788PAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Three Rivers Cardiac Institute Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jennifer.l.grace@upmcdirect.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1013988401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 BROOKTREE RD",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150909254",
            "telephone_number": "412-367-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 BROOKTREE RD",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150909254",
            "telephone_number": "412-367-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-01",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA051788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wexford, PA

Sources for this page

Verify at the official NPI Registry.