Active NPI
Anita Clarke, NP
- Adult Health Nurse Practitioner
- New York, NY
National Provider Identifier
1184772279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 302417
- Practice address
- 1 Penn Plaza, 7TH FL, Ste. 725
New York, NY 10119 - Phone
- (800) 842-2478
- Fax
- (212) 216-6606
- NPI assigned
- Jan 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 302417 | NY | Primary |
Addresses
Primary practice location
1 Penn Plaza, 7TH FL, Ste. 725
New York, NY 10119
Mailing address
9900 Bren Rd E
Mail Route MN 008-B213
Minnetonka, MN 55343-9664
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150320001291 | NY | Order and Referring Only - Nurse Practitioner | 6800113382 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 302417 | NY | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optum Care Services Company | Adult Health | Past | Accepting new patients |
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": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605225600000",
"number": "1184772279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9900 BREN RD E",
"address_2": "MAIL ROUTE MN 008-B213",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553439664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 PENN PLAZA, 7TH FL, STE. 725",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10119",
"telephone_number": "800-842-2478",
"fax_number": "212-216-6606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARKE",
"first_name": "ANITA",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-08",
"last_updated": "2020-11-13",
"certification_date": "2020-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "302417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.