Susannah J. Clark, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA3930 Issued in MA

Practice address

275 Varnum Ave Ste 203
Lowell, MA 01854-2109

Phone

(978) 458-4300

Fax

(978) 458-4311

NPI assigned

Feb 25, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beth Israel Lahey Health Specialty Care, Inc.Group PAC ID 2365405024, 264 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Winchester Hospital Hospital, Winchester, MA, CCN 220105
• Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sclark134809@direct.bmc.masshiway.net

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.

• Beth Israel Lahey Health Specialty Care, Inc.

  • Internal Medicine Physician
  • Gloucester, MA
  • NPI 1235147760
  Medicare reassignment Care Compare group NPD
• Steward Medical Group, Inc

  • Specialist
  • Watertown, MA
  • NPI 1629398219
  Medicare reassignment NPD
• BMC Affiliated Physicians, Inc.

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1245320910
  Medicare reassignment
• Emerson Practice Associates, Inc.

  • Internal Medicine Physician
  • Concord, MA
  • NPI 1508020199
  Medicare reassignment
• Winchester Physician Associates, Inc

  • Internal Medicine Physician
  • Winchester, MA
  • NPI 1184606865
  Medicare reassignment
• Beth Israel Lahey Health Specialty Care, Inc.

  dba Lahey Institute of Urology, Beverly

  • Urology Physician
  • Burlington, MA
  • NPI 1427161660
  NPD
• Steward Medical Group, Inc

  • Specialist
  • Brighton, MA
  • NPI 1356654495
  NPD

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

• Lahey Clinic Hospital, Inc.

  • General Acute Care Hospital
  • Burlington, MA
  • NPI 1558392563
  Care Compare affiliation
• Winchester Hospital

  • General Acute Care Hospital
  • Winchester, MA
  • NPI 1790740777
  Care Compare affiliation

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

{
    "created_epoch": "1267056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1770805202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 VARNUM AVE STE 203",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018542109",
            "telephone_number": "978-458-4300",
            "fax_number": "978-458-4311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 VARNUM AVE STE 203",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018542109",
            "telephone_number": "978-458-4300",
            "fax_number": "978-458-4311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "235 N Pearl St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023011794",
            "country_code": "US",
            "telephone_number": "508-427-3180",
            "fax_number": "508-427-2209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SUSANNAH",
        "middle_name": "J.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-25",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA3930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110121498A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John J. Clarity, D.P.M.
• Alexandria Faith Clark
• Elizabeth Ashley Clark
• Kathryn Louise Clark, RD LDN
• Sarah Clark
• Arline Clarke, LMHC
• Emily Rose Claude, MS, APRN, FNP-C
• Diane Christine Clavette, MA MHC
• Sara Larson Clay, MD
• Andrea Cleghorn, LCSW

• Physician Assistant in Lowell, MA
• Providers in Lowell, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.