Individual provider Active NPI

Alexandra Clark, NP

  • Family Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1043829641
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
346254 Issued in NY
Practice address
200 Canal View Blvd Ste 100
Rochester, NY 14623-2850
Phone
(585) 444-8422
Fax
(585) 444-8815
NPI assigned
Jul 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X 346254 NY
Family Nurse Practitioner 363LF0000X 346254 NY Primary

Addresses

Primary practice location

200 Canal View Blvd Ste 100
Rochester, NY 14623-2850

Mailing address

200 Canal View Blvd Ste 100
Rochester, NY 14623-2850
Phone (585) 444-8422

Other practice location 1

601 Elmwood Ave
Rochester, NY 14642-0001
Phone (585) 275-1611

Other practice location 2

160 Sawgrass Dr Ste 120
Rochester, NY 14620-4654
Phone (585) 275-1611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20201015000370 NY Practitioner - Nurse Practitioner 8224458153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Flower City Dermatology PCGroup PAC ID 4082090923, 3 clinicians

Practice addresses (Care Compare)

200 Canal View Blvd
Suite 100
Rochester, NY 14623-2850
Phone (585) 444-8422

Merit-based Incentive Payment System (MIPS)

Final score
94.97 of 100Reported as group
Quality
70.96
Promoting interoperability
100
Improvement activities
40
Cost
82.24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
346254NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Flower City Dermatology PC CurrentSince Jan 6, 2025 Accepting new patients

Locations

200 Canal View Blvd
Ste 100
Rochester, NY 14623
Phone (585) 444-8422

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ez_00132

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1043829641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CANAL VIEW BLVD STE 100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146232850",
            "telephone_number": "585-444-8422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CANAL VIEW BLVD STE 100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146232850",
            "telephone_number": "585-444-8422",
            "fax_number": "585-444-8815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Elmwood Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146420001",
            "country_code": "US",
            "telephone_number": "585-275-1611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "160 Sawgrass Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146204654",
            "country_code": "US",
            "telephone_number": "585-275-1611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ALEXANDRA",
        "name_prefix": "Miss",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-29",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "NY",
            "license": "346254",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "346254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.