MR. TYLER MATTHEW CLARK PA-C
NPI 1356093322
Physician Assistant in Van Nuys, CA
About Mr. Tyler Matthew Clark Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. TYLER MATTHEW CLARK PA-C (NPI 1356093322) is an individual physician assistant in Van Nuys, California, licensed in California (PA60472) and active in the NPI registry since January 2022. He is enrolled in Medicare PECOS and maintains a secondary practice location in Mission Hills.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mr. Tyler Matthew Clark Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 91405 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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.
VAN NUYS, CA 91405
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 Tyler Clark's NPI number?
The NPI number for Tyler Clark is 1356093322. It was assigned to this individual provider in the NPPES registry on January 21, 2022.
Where is Tyler Clark located?
Tyler Clark practices at 6815 Noble Ave, Van Nuys, CA 91405. The listed phone number is (818) 901-6600.
What is Tyler Clark's specialty?
The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.
Is Tyler Clark enrolled in Medicare?
Yes. Tyler Clark is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Tyler Clark was last updated on August 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 days 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.
# Mr. Tyler Matthew Clark, PA-C · NPI 1356093322
Physician Assistant physician in Van Nuys, California. Individual provider, active in the CMS NPPES registry since January 21, 2022.
## Identity
- **NPI:** 1356093322 (Entity type: Individual)
- **Enumerated:** January 21, 2022
- **Primary specialty:** Physician Assistant · taxonomy 363A00000X
- **State license:** PA60472 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 6815 NOBLE AVE, Van Nuys, CA 91405-3796
- **Phone:** (818) 901-6600
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** August 3, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1356093322) · Data from the CMS NPPES public registry.