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JESSICA MARION CLARK PMHNP
NPI 1457914160
Nurse Practitioner - Psychiatric/Mental Health in Saint Paul, MN

Active since April 18, 2019PECOS EnrolledAccepts Medicare Assignment
2265 COMO AVE, SAINT PAUL, MN 55108(866) 821-0821 Get Directions Write a Review

NPPES record last updated: May 15, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 15, 2026, Jan 5, 2022, Oct 10, 2019 and 1 more (4 updates tracked since 2019).

About Jessica Marion Clark Pmhnp NPPES

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

JESSICA MARION CLARK PMHNP (NPI 1457914160) is an individual psychiatric/mental health provider in Saint Paul, Minnesota, licensed in Minnesota (6747) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS, maintains a secondary practice location in Saint Paul, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1457914160
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameJESSICA MARION CLARKCredential: PMHNP
Location Address2265 COMO AVESaint Paul, MN 55108-1737
Mailing Address2265 Como AveSaint Paul, MN 55108-1737 · (651) 645-5323
Phone(866) 821-0821
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateApril 18, 2019
Last NPPES UpdateMay 15, 20264 updates tracked since enumeration
NPPES CertifiedMay 15, 2026
✔ NPI 1457914160 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in MN · 6747
2265 COMO AVE, Saint Paul, MN 55108
Open in Google Maps ↗

Secondary Practice Location 1

Location 1640 Jackson StSaint Paul, MN 55101-2502 · Phone (651) 254-3456

Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jessica Marion Clark Pmhnp 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 ID7315274164
PECOS Enrollment IDI20190816000773
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 Reassignments

3

Medicare enrollment records show Jessica Clark reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Emily Program P C
Same address
Mental Health (Including Community Mental Health Center)
2265 COMO AVENUE, SUITE 100
St Paul, MN 55108
  • Reassigned Medicare billing, Minnesota enrollment
  • 121 clinicians in this Medicare group
NPI 1528165065 (866) 364-5977
Group Health, Inc.
0.5 mi
Oral and Maxillofacial Surgery
2500 COMO AVE
Saint Paul, MN 55108
  • Reassigned Medicare billing, Minnesota enrollment
  • 2,274 clinicians in this Medicare group
NPI 1225629017 (651) 647-2500
Summit Clinics PLLC
8.6 mi
Psychiatry
2115 COUNTY ROAD D E STE C
Maplewood, MN 55109
  • Reassigned Medicare billing, Minnesota enrollment
  • 6 clinicians in this Medicare group
NPI 1285290072 (651) 955-6747

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 55108 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
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
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.

MICHAEL HILMAR WAGNER R.D., L.D.
Nutritionist
2265 COMO AVE
SAINT PAUL, MN 55108
Ramsey County (888) 364-5977
MISS KELLY PERTZSCH MA
Counselor (Professional)
2265 COMO AVE
SAINT PAUL, MN 55108
Ramsey County (651) 645-5325
STEFANIE KAITLYN JENSEN RD, LD
Dietitian, Registered
2265 COMO AVE
SAINT PAUL, MN 55108
Ramsey County (888) 364-5977
KRISTA WANOUS MA, MFT, AT
Student in an Organized Health Care Education/Training Program
2265 COMO AVE
SAINT PAUL, MN 55108
Ramsey County (651) 645-5323
LINNEA MCCOSH
Marriage & Family Therapist
2265 COMO AVE
SAINT PAUL, MN 55108
Ramsey County (888) 364-5977
ARIEL SYVERTSON
Counselor (Professional)
2265 COMO AVE
SAINT PAUL, MN 55108
Ramsey County (888) 364-5977
DEANNA MILLER
Dietitian, Registered
2265 COMO AVE
SAINT PAUL, MN 55108
Ramsey County (651) 645-5323
LINDSEY STIYER RD
Dietitian, Registered
2265 COMO AVE
SAINT PAUL, MN 55108
Ramsey County (651) 645-5323

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 Jessica Clark's NPI number?

The NPI number for Jessica Clark is 1457914160. It was assigned to this individual provider in the NPPES registry on April 18, 2019.

Where is Jessica Clark located?

Jessica Clark practices at 2265 Como Ave, Saint Paul, MN 55108. The listed phone number is (866) 821-0821.

What is Jessica Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Jessica Clark enrolled in Medicare?

Yes. Jessica Clark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Jessica Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jessica Clark reassigns Medicare benefits to 3 organizations: Emily Program P C (St Paul, MN), Group Health, Inc. (Saint Paul, MN) and Summit Clinics PLLC (Maplewood, MN). Each 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 Jessica Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jessica Clark accept?

Health plans from HealthPartners list Jessica 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 Jessica Clark was last updated on May 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.