Jennifer A Clark, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

243576 Issued in NY

Practice address

3950 E. Robinson Rd.
Ste. 205
West Alherst, NY 14228-2044

Phone

(716) 691-3400

Fax

(716) 691-3404

NPI assigned

Mar 29, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jenniferclarkmd@mhawny.medentdirect.com

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.

• Medical Health Associates of Western New York PLLC

  • Pediatrics Physician
  • Williamsville, NY
  • NPI 1013453273
  NPD
• Tonawanda Pediatrics LLP

  • Pediatrics Physician
  • West Amherst, NY
  • NPI 1861437279
  NPD (past)
• Western New York Pediatric Associates, LLP

  • Pediatrics Physician
  • Orchard Park, NY
  • NPI 1538257977
  NPD (past)
• PL Pediatrics, PLLC

  • Pediatrics Physician
  • Fredericksburg, VA
  • NPI 1518998236
  NPD (past)
• PL Physicians, Inc.

  • Pediatrics Physician
  • Fredericksburg, VA
  • NPI 1972530210
  NPD (past)

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1962522664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8205 MAIN ST STE 10",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216054",
            "telephone_number": "716-539-0789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 E. ROBINSON RD.",
            "address_2": "STE. 205",
            "city": "WEST ALHERST",
            "state": "NY",
            "postal_code": "142282044",
            "telephone_number": "716-691-3400",
            "fax_number": "716-691-3404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "2435761",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "243576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962522664",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; 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.