Stephanie Amdur-Clark, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

383057 Issued in NY

Practice address

601 Elmwood Ave
Rochester, NY 14642-2548

Phone

(585) 275-7520

NPI assigned

Feb 4, 2016

Reactivated

Sep 30, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: samdurclark193656@direct.urmc.rochester.edu

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.

• Pediatria Healthcare, LLC

  dba Pediatria HealthCare for Kids

  • Home Health Agency
  • North Versailles, PA
  • NPI 1134563711
  NPD (past)

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

{
    "created_epoch": "1454544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1851759872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 TIMBER CV APT D",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145803100",
            "telephone_number": "716-548-1258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146422548",
            "telephone_number": "585-275-7520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "196 Boston Tpke",
            "address_purpose": "LOCATION",
            "city": "Shrewsbury",
            "state": "MA",
            "postal_code": "015452548",
            "country_code": "US",
            "telephone_number": "508-796-4706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMDUR-CLARK",
        "first_name": "STEPHANIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-04",
        "last_updated": "2023-07-03",
        "deactivation_date": "2019-09-10",
        "reactivation_date": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "MA",
            "license": "RN2299120",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "383057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "samdurclark193656@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "samdurclark193656@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Matthew Ambalavanar, MD
• Shelley Ambeau, RN
• Robert D Ambrosini, M.D.
• William Neil Ambrosini, M.D.
• Filip Ambrosio, D.D.S
• Clifford J Ameduri, M.D.
• Nancy L Amell, NP
• Patrick Anthony Amendolare, PHARMACIST
• America's Best Contacts & Eyeglasses
• American Acupuncture Clinic

• Pediatric Nurse Practitioner in Rochester, NY
• Providers in Rochester, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.