Individual provider Active NPI

Tomi Li Clark, PA-C

  • Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1205629797
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10004923A Issued in IN
Practice address
8450 Northwest Blvd
Indianapolis, IN 46278-1381
Phone
(317) 802-2000
Fax
(317) 802-2170
NPI assigned
May 27, 2025
Last updated
Jun 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10004923A IN Primary

Addresses

Primary practice location

8450 Northwest Blvd
Indianapolis, IN 46278-1381

Mailing address

8450 Northwest Blvd
Indianapolis, IN 46278-1381
Phone (317) 802-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tomi.clark.1@29985.direct.athenahealth.com Orthopaedics-Indianapolis, Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20250821003799 IN Practitioner - Physician Assistant 6800396128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedics-Indianapolis IncGroup PAC ID 7416860663, 357 clinicians

Practice addresses (Care Compare)

288 E 175TH St
Suite 100
Westfield, IN 46074-8934
Phone (317) 275-6140

8450 Northwest Blvd
Indianapolis, IN 46278-1381
Phone (317) 802-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PENDINGINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedics-Indianapolis, Inc CurrentSince Jul 29, 2025 Accepting new patients
Orthopaedics-Indianapolis, Inc CurrentSince Jul 29, 2025 Accepting new patients
Orthopaedics-Indianapolis, Inc Physician Assistant Past Accepting new patients

Locations

8450 Northwest Blvd
Indianapolis, IN 46278

Interoperability endpoints

  • Direct secure messaging: tomi.clark.1@29985.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1748304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1205629797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8450 NORTHWEST BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462781381",
            "telephone_number": "317-802-2000",
            "fax_number": "317-802-2170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8450 NORTHWEST BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462781381",
            "telephone_number": "317-802-2000",
            "fax_number": "317-802-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TOMI",
        "middle_name": "LI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-27",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10004923A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tomi.clark.1@29985.direct.athenahealth.com",
            "affiliation": "Y",
            "endpointDescription": "Athena address",
            "affiliationName": "Orthopaedics-Indianapolis, Inc",
            "address_1": "8450 Northwest Blvd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462781381",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.