Individual provider Active NPI

Mandy Clark, NP

  • Nurse Practitioner
  • Elmira, NY
National Provider Identifier
1740616846
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
338054 Issued in NY
Practice address
600 Roe Ave Ste 1a
Elmira, NY 14905-1676
Phone
(607) 737-4130
Fax
(607) 737-4530
NPI assigned
Sep 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0000021347 TN
Nurse Practitioner 363L00000X 338054 NY Primary

Addresses

Primary practice location

600 Roe Ave Ste 1a
Elmira, NY 14905-1676

Mailing address

571 Saint Josephs Blvd FL 2
Elmira, NY 14901-3230
Phone (607) 271-2050

Other practice location 1

1 Medical Center Blvd
Cookeville, TN 38501-4294
Phone (931) 528-2541

Other identifiers 1

IdentifierTypeStateIssuer
03802251MedicaidNY

Other names 1

  • Mandy Steiner Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140205001288 NY Practitioner - Nurse Practitioner 9739318130 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arnot Medical Services PLLCGroup PAC ID 0840450748, 91 clinicians
Arnot Ogden Medical CenterGroup PAC ID 5395798417, 219 clinicians

Practice addresses (Care Compare)

600 Roe Ave
Elmira, NY 14905-1629
Phone (607) 737-7770

Hospital & facility affiliations

  • Arnot Ogden Medical Center Hospital, Elmira, NY, CCN 330090
  • Cayuga Medical Center at Ithaca Hospital, Ithaca, NY, CCN 330307

Merit-based Incentive Payment System (MIPS)

Final score
81.64 of 100Reported as group
Quality
55.31
Promoting interoperability
99
Improvement activities
40
Cost
76.8

Merit-based Incentive Payment System (MIPS)

Final score
80.15 of 100Reported as group
Quality
46.76
Promoting interoperability
100
Improvement activities
40
Cost
77.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0000021347TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arnot Ogden Medical Center CurrentSince Oct 1, 2021 Accepting new patients
Arnot Ogden Medical Center CurrentSince Oct 1, 2021 Accepting new patients

Locations

600 Roe Ave
#1A
Elmira, NY 14905
Phone (607) 737-4130

600 Roe Ave
Elmira, NY 14905
Phone (607) 733-3639

600 Fitch St
Ste 202
Elmira, NY 14905
Phone (607) 735-5764

600 Roe Ave
Ste 1F
Elmira, NY 14905
Phone (607) 795-8161

600 Roe Ave
Ste 1A
Elmira, NY 14905
Phone (607) 737-4130

Interoperability endpoints

  • Direct secure messaging: mandy.clark@arn.eclinicaldirectplus.com
  • Direct secure messaging: mclark26831@direct.xtensys.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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1379635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1740616846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 SAINT JOSEPHS BLVD FL 2",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013230",
            "telephone_number": "607-271-2050",
            "fax_number": "607-873-1244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ROE AVE STE 1A",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149051676",
            "telephone_number": "607-737-4130",
            "fax_number": "607-737-4530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Cookeville",
            "state": "TN",
            "postal_code": "385014294",
            "country_code": "US",
            "telephone_number": "931-528-2541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MANDY",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-20",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "0000021347",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "338054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03802251",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDY",
            "last_name": "STEINER",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elmira, NY

Sources for this page

Verify at the official NPI Registry.