NPIMap

Individual provider Active NPI

Anton Victor Clark, PA-C

  • Medical Physician Assistant
  • Anchorage, AK
National Provider Identifier
1487372116
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
217139 Issued in AK
Practice address
3801 Lake Otis Pkwy Ste 300
Anchorage, AK 99508-5234
Phone
(907) 562-2277
Fax
(907) 563-3460
NPI assigned
Aug 18, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 217139 AK Primary

Addresses

Primary practice location

3801 Lake Otis Pkwy Ste 300
Anchorage, AK 99508-5234

Mailing address

3801 Lake Otis Pkwy Ste 300
Anchorage, AK 99508-5234
Phone (907) 562-2277

Other identifiers 1

IdentifierTypeStateIssuer
1744081MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240209003130 AK Practitioner - Physician Assistant 3779926308 Reassigns benefits to 1 organization
I20260420000111 TX Practitioner - Physician Assistant 3779926308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthoalaska LLCGroup PAC ID 2961705520, 167 clinicians
Alaska Native Tribal Health ConsortiumGroup PAC ID 6709780265, 605 clinicians

Practice addresses (Care Compare)

3801 Lake Otis Pkwy
Anchorage, AK 99508-5234

3801 University Lake Dr
Anchorage, AK 99508-4658
Phone (907) 563-2662

Hospital & facility affiliations

  • Alaska Native Medical Center Hospital, Anchorage, AK, CCN 020026
  • Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001
  • Alaska Regional Hospital Hospital, Anchorage, AK, CCN 020017

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
217139AKMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthoalaska LLC CurrentSince Jan 1, 2024 Accepting new patients
Orthoalaska, LLC Past Accepting new patients
Orthoalaska, LLC Physician Assistant Past Accepting new patients
Orthoalaska LLC PastSince Jan 21, 2024 Accepting new patients

Locations

3801 Lake Otis Pkwy
Ste 300
Anchorage, AK 99508
Phone (907) 341-5238

3125 E Meridian Park Loop
Ste 300
Wasilla, AK 99654
Phone (907) 357-2267

Interoperability endpoints

  • Direct secure messaging: anton.clark.p1@direct.opaak.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1487372116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 LAKE OTIS PKWY STE 300",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085234",
            "telephone_number": "907-562-2277",
            "fax_number": "907-563-3460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 LAKE OTIS PKWY STE 300",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085234",
            "telephone_number": "907-562-2277",
            "fax_number": "907-563-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ANTON",
        "middle_name": "VICTOR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-18",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AK",
            "license": "217139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1744081",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.