Andrea May Clark, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

102892 Issued in AK

Practice address

4951 Business Park Blvd
Anchorage, AK 99503-7174

Phone

(907) 743-7200

NPI assigned

Jun 20, 2012

Last updated

May 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Iowa, RJ & L Carver College of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Providence Health and Services- WashingtonGroup PAC ID 1557408176, 219 clinicians

Anchorage Neighborhood Health Center IncGroup PAC ID 0941107288, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence at Home With Compassus HH Anchorage Home health agency, Anchorage, AK, CCN 027001
• Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aclark131756@ak.providencedirect.org

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

• Anchorage Neighborhood Health Center Inc

  • Family Medicine Physician
  • Anchorage, AK
  • NPI 1811170210
  Medicare reassignment Care Compare group NPD
• Providence Health & Services- Washington

  dba Providence Medical Group Alaska

  • Critical Care Medicine (Internal Medicine) Physician
  • Anchorage, AK
  • NPI 1093956278
  Medicare reassignment Care Compare group
• Anchorage Neighborhood Health Center, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Anchorage, AK
  • NPI 1184367195
  NPD
• Providence Health & Services-Washington

  dba Providence Medical Group Alaska

  • Community/Behavioral Health Agency
  • Anchorage, AK
  • NPI 1841814795
  NPD
• Cityblock Medical Practice, P.a.

  • Internal Medicine Physician
  • Indianapolis, IN
  • NPI 1588296784

  Family Medicine

  NPD (past)
• Columbus Regional Health Network

  dba Advanced Primary Care

  • Family Medicine Physician
  • Whiteville, NC
  • NPI 1518263268
  NPD (past)

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

• CP Ak HH, LLC

  dba Providence at Home with Compassus Home Health, Anchorage

  • Home Health Agency
  • Anchorage, AK
  • NPI 1134941156
  Care Compare affiliation
• Providence Health & Services Washington

  dba Providence Alaska Medical Center

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1053363119
  Care Compare affiliation

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1063775427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4951 BUSINESS PARK BLVD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995037174",
            "telephone_number": "907-743-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4951 BUSINESS PARK BLVD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995037174",
            "telephone_number": "907-743-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 E 36th Ave",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995084372",
            "country_code": "US",
            "telephone_number": "907-562-9229",
            "fax_number": "907-561-4806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ANDREA",
        "middle_name": "MAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-20",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "102892",
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "MA",
            "license": "4951",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1579312",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan J Clancy, MD
• Sandra Clapper, CNM ANP
• Katrina Clarey
• Claritherapy LLC
• Adam Clark, OD
• Anton Victor Clark, PA-C
• Christine D Clark, MD
• Cynthia Clark
• Deanna Clark, MS,CCC-SLP
• James A Clark, DMD,MS

• Family Medicine Physician in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Family Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.