SAMUEL CLARK AGACNP
NPI 1417706623
Nurse Practitioner - Acute Care in Newark, DE

Q: What is Samuel Clark's NPI number?

The NPI number for Samuel Clark is 1417706623. It was assigned to this individual provider in the NPPES registry on May 20, 2024.

Q: What is Samuel Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Clark was last updated on July 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since May 20, 2024PECOS EnrolledAccepts Medicare Assignment

4755 OGLETOWN STANTON RD STE 2E99, NEWARK, DE 19718(302) 733-5982(302) 733-6081 Get Directions Write a Review

NPPES record last updated: July 12, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Samuel Clark Agacnp NPPES

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

SAMUEL CLARK AGACNP (NPI 1417706623) is an individual acute care provider in Newark, Delaware, licensed in Delaware (LP-0010513) and active in the NPI registry since May 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1417706623

Entity TypeIndividualMale

Primary Taxonomy363LA2100X

Provider Legal NameSAMUEL CLARKCredential: AGACNP

Location Address4755 OGLETOWN STANTON RD STE 2E99Newark, DE 19718-2200

Mailing Address3566 Main StFrederica, DE 19946-1265 · (302) 632-7359

Phone(302) 733-5982

Fax(302) 733-6081

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateMay 20, 2024

Last NPPES UpdateJuly 12, 2024

NPPES CertifiedJuly 12, 2024

✔ NPI 1417706623 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in DE · LP-0010513

Also ListedRegistered NurseTaxonomy 163W00000X · License L1-0048020 (DE)

Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X · License LP-0010513 (DE)

4755 OGLETOWN STANTON RD STE 2E99, Newark, DE 19718

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and more.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

Samuel Clark Agacnp 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 ID941747398

PECOS Enrollment IDI20240802000357

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 2

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

39 services36 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

20 services20 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19718 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

$88.37 typical visit price

range $57.12 – $173.08

Typical copayment $22.09 (range $14.28 – $43.27)

Most-billed visit code 99203

Established Patient

$100.68 typical visit price

range $18.36 – $141.05

Typical copayment $25.17 (range $4.59 – $35.26)

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.

CORINNE S PALACIO PA-C

Physician Assistant