Andrew Thomas Clark, FNP-BC, DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

343027 Issued in NY

Practice address

1270 Avenue of the Americas Ste 757
New York, NY 10020-1700

Phone

(646) 248-7651

NPI assigned

May 8, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1609365352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 DARK HOLLOW RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 AVENUE OF THE AMERICAS STE 757",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100201700",
            "telephone_number": "646-248-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ANDREW",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "FNP-BC, DNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-08",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "343027",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NY",
            "license": "690785",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrian Clark, DPT
• Aileen Clark, PH.D.
• Alex Clark, FNP-BC, RN
• Allison Kaye Clark, PMHNP-BC DNP
• Andrea Clark, LCSW
• Ashleigh L Clark, PA
• Barbara Clark, LCSW
• Barbara Oliver Clark, LCSW
• Barry James Clark, CASAC-T
• Bashawn Clark, LMSW

• Family Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; 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.

Verify at the official NPI Registry.