Jennifer Clark, P. A.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

550 W Ogden Ave
Hinsdale, IL 60521-3186

Phone

(630) 323-6116

Fax

(630) 794-8620

NPI assigned

Oct 26, 2016

Last updated

Oct 26, 2016By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Progressive Surgical Associates SCGroup PAC ID 0042358673, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DHDHAA/Endpoint/DHDHAA

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.

• Progressive Surgical Associates SC

  • Surgery Physician
  • New Lenox, IL
  • NPI 1154550226
  Medicare reassignment Care Compare group

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

• Silver Cross Hospital & Medical Centers

  • Rehabilitation Hospital Unit
  • New Lenox, IL
  • NPI 1003933797
  Care Compare affiliation
• Silver Cross Hospital & Medical Centers

  dba Silver Cross Hospital

  • General Acute Care Hospital
  • New Lenox, IL
  • NPI 1568553519
  Care Compare affiliation

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477440000000",
    "number": "1114479052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2138 PRENTISS DR",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605165314",
            "telephone_number": "630-323-6116",
            "fax_number": "630-794-8620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 W OGDEN AVE",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213186",
            "telephone_number": "630-323-6116",
            "fax_number": "630-794-8620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JENNIFER",
        "credential": "P. A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-26",
        "last_updated": "2016-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chris Nikolovski DDS PC
• Christina G Steil Dermatology LTD (CSC Dermatology)
• Christina J. Scalise Morrissey
• CHT Orthodontics
• Cynthia Clark-Zurawski, MSN APRN FNP-BC
• CNS Spine P.C.
• Alexandra Colaianni, MS, LCSW
• Mara Janelle Coleman, LPC
• Jeffrey K Collins, DDS
• Michael J Collins, M.D.

• Surgical Physician Assistant in Hinsdale, IL
• Providers in Hinsdale, IL by specialty
• Surgical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; 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.