1. Home
  2. Directory
  3. New York
  4. Vestal
  5. Social Worker
  6. NPI Profile

KELLY ANNE CLARK
NPI 1073083788
Social Worker - Clinical in Vestal, NY

Active since November 26, 2018PECOS Enrolled
1715 CASTLE GARDENS RD, VESTAL, NY 13850(607) 341-7017 Get Directions Write a Review

NPPES record last updated: November 26, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kelly Anne Clark NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY ANNE CLARK (NPI 1073083788) is an individual clinical provider in Vestal, New York, licensed in New York (075351) and active in the NPI registry since November 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073083788
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKELLY ANNE CLARK
Location Address1715 CASTLE GARDENS RDVestal, NY 13850-1175
Mailing Address93 Park AveBinghamton, NY 13903-3226 · (607) 321-5179
Phone(607) 341-7017
Sole ProprietorYes
Enumeration DateNovember 26, 2018
✔ NPI 1073083788 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in NY · 075351
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
1715 CASTLE GARDENS RD, Vestal, NY 13850
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Anne Clark is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kelly Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Our Lady Of Lourdes Memorial Hospital Inc.
7.5 mi
General Acute Care Hospital
169 RIVERSIDE DR
Binghamton, NY 13905
  • Reassigned Medicare billing, New York enrollment
  • 386 clinicians in this Medicare group
NPI 1629087580 (607) 798-5111

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13850 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $54.87 – $166.88
Typical copayment $0.00 (range $13.71 – $41.72)
Most-billed visit code NA
Established Patient
$68.57 typical visit price
range $17.54 – $136.14
Typical copayment $17.14 (range $4.38 – $34.03)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TIFFANY ANN JOHNSON OT
Occupational Therapist
1715 CASTLE GARDENS RD
VESTAL, NY 13850
Broome County (607) 484-5079
ANJANA ASHOK
Physical Therapist
1715 CASTLE GARDENS RD, SUITE 105
VESTAL, NY 13850
Broome County (607) 484-5079
HEARTH MANAGEMENT, LLC
Assisted Living Facility
1715 CASTLE GARDENS RD
VESTAL, NY 13850
Broome County (607) 748-5700
COLLEEN HEATHER KUSSARD DPT
Physical Therapist
1715 CASTLE GARDENS RD
VESTAL, NY 13850
Broome County (607) 484-5079
JENNIFER WASILESKI OTR/L
Occupational Therapist
1715 CASTLE GARDENS RD
VESTAL, NY 13850
Broome County (607) 748-5700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Clark's NPI number?

The NPI number for Kelly Clark is 1073083788. It was assigned to this individual provider in the NPPES registry on November 26, 2018.

Where is Kelly Clark located?

Kelly Clark practices at 1715 Castle Gardens Rd, Vestal, NY 13850. The listed phone number is (607) 341-7017.

What is Kelly Clark's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Kelly Clark enrolled in Medicare?

Yes. Kelly Clark is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kelly Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Clark reassigns Medicare benefits to Our Lady Of Lourdes Memorial Hospital Inc. (Binghamton, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kelly Clark accept?

Health plans from Oscar Health list Kelly Clark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kelly Clark was last updated on November 26, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.