MRS. KOLU S. BAYSAH CLARK DNP
NPI 1336535624
Nurse Practitioner - Gerontology in Warwick, RI

Q: What is Kolu Baysah Clark's NPI number?

The NPI number for Kolu Baysah Clark is 1336535624. It was assigned to this individual provider in the NPPES registry on April 13, 2015.

Q: What is Kolu Baysah Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Q: When was this NPI record last updated?

The NPPES record for Kolu Baysah Clark was last updated on April 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.

Active since April 13, 2015PECOS EnrolledAccepts Medicare Assignment

455 TOLL GATE RD, WARWICK, RI 02886(401) 737-7010 Get Directions Write a Review

NPPES record last updated: April 15, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 15, 2026, Dec 21, 2021, Mar 25, 2021 and 1 more (4 updates tracked since 2020).

On this page

About Mrs. Kolu S. Baysah Clark Dnp NPPES

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

MRS. KOLU S. BAYSAH CLARK DNP (NPI 1336535624) is an individual gerontology provider in Warwick, Rhode Island, licensed in Rhode Island (APRN00086) and active in the NPI registry since April 2015. She is enrolled in Medicare PECOS, is affiliated with Umass Memorial Medical Center/university Campus, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1336535624

Entity TypeIndividualFemale

Primary Taxonomy363LG0600X

Provider Legal NameMRS. KOLU S. BAYSAH CLARKCredential: DNP

Location Address455 TOLL GATE RDWarwick, RI 02886-2759

Mailing Address455 Tollgate Rd, Professional Revenue Cycle And CredentialingWarwick, RI 02886-2759 · (401) 273-0641 · Fax (401) 273-2919

Phone(401) 737-7010

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateApril 13, 2015

Last NPPES UpdateApril 15, 20264 updates tracked since enumeration

NPPES CertifiedApril 15, 2026

✔ NPI 1336535624 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in RI · APRN00086

Also ListedNurse PractitionerTaxonomy 363L00000X · License RN2269378 (MA), APRN00086 (RI)

Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X · License APRN00086 (RI), RN2269378 (MA)

455 TOLL GATE RD, Warwick, RI 02886

Open in Google Maps ↗

Secondary Practice Locations 3

Location 11 Harvard RdShirley, MA 01464-2434 · Phone (978) 425-4341 ext. 4405

Location 2593 Eddy StProvidence, RI 02903-4923 · Phone (401) 793-9166 · Fax (401) 444-2788

Location 355 Lake Ave NWorcester, MA 01655-0002 · Phone (508) 334-8515 · Fax (508) 334-6490

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Kolu S. Baysah Clark Dnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9335441237

PECOS Enrollment IDI20210126003036

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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

12 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Umass Memorial Medical Center/University Campus

Acute Care Hospitals · Worcester, MA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220163

Location55 Lake Avenue NorthWorcester, MA 01655 · Worcester County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02886 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

$90.48 typical visit price

range $58.57 – $177.03

Typical copayment $22.62 (range $14.64 – $44.25)

Most-billed visit code 99203

Established Patient

$103.10 typical visit price

range $18.92 – $144.38

Typical copayment $25.77 (range $4.73 – $36.09)

Most-billed visit code 99214

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 20

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

DR. STERLING LEAF MALISH M.D.

Internal Medicine