Active NPI
Jessica A. Clark, PH.D.
- Clinical Neuropsychologist
- Washington, DC
National Provider Identifier
1831458470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- Practice address
- 102 Irving St NW
Washington, DC 20010-2921 - Phone
- (202) 877-1915
- NPI assigned
- May 15, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | Primary |
Addresses
Primary practice location
102 Irving St NW
Washington, DC 20010-2921
Mailing address
13225 Bellevue St
Silver Spring, MD 20904-1704
Phone (610) 331-2229
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1145 19TH St NW
311 MMG at 19TH Street NW
Washington, DC 20036-3735
Phone (202) 429-2401
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.34 of 100
- Quality
- 67.9
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 69.47
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06406 | MD | MD | Occupational Therapist |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337040000000",
"number": "1831458470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13225 BELLEVUE ST",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209041704",
"telephone_number": "610-331-2229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 IRVING ST NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200102921",
"telephone_number": "202-877-1915"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "JESSICA",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-15",
"last_updated": "2012-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2012; 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.