JENNIFER JEAN CLARK PA
NPI 1730631490
Physician Assistant in Provo, UT

Q: What is Jennifer Clark's NPI number?

The NPI number for Jennifer Clark is 1730631490. It was assigned to this individual provider in the NPPES registry on October 28, 2016.

Q: What is Jennifer Clark's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Jennifer Clark was last updated on December 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 October 28, 2016PECOS EnrolledAccepts Medicare Assignment

92.06/100

CMS Quality Rating

1055 N 500 W STE 212, PROVO, UT 84604(801) 812-5033(801) 812-5034 Get Directions Write a Review

NPPES record last updated: December 3, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 3, 2022, Oct 19, 2018, Oct 28, 2016 (3 updates tracked since 2016).

On this page

About Jennifer Jean Clark Pa NPPES

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

JENNIFER JEAN CLARK PA (NPI 1730631490) is an individual physician assistant in Provo, Utah, licensed in Utah (10132491-1206) and active in the NPI registry since October 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1730631490

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameJENNIFER JEAN CLARKCredential: PA

Location Address1055 N 500 W STE 212Provo, UT 84604-3305

Mailing Address1055 N 500 W, Attn: CredentialingProvo, UT 84604-3305 · (801) 354-8225 · Fax (801) 418-0941

Phone(801) 812-5033

Fax(801) 812-5034

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateOctober 28, 2016

Last NPPES UpdateDecember 3, 20223 updates tracked since enumeration

NPPES CertifiedDecember 3, 2022

✔ NPI 1730631490 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in UT · 10132491-1206

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1055 N 500 W STE 212, Provo, UT 84604

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Accepted Insurance

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

Jennifer Jean Clark Pa 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 ID6305126335

PECOS Enrollment IDI20161209000870

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 5

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

40 services40 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

25 services25 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

18 services18 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

13 services13 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84604 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

$84.41 typical visit price

range $54.34 – $166.03

Typical copayment $21.10 (range $13.58 – $41.50)

Most-billed visit code 99203

Established Patient

$68.01 typical visit price

range $17.23 – $135.20

Typical copayment $17.00 (range $4.30 – $33.80)

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.

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.

92.06/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

85.57

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 8

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

MERILEE JACOBSON FNP

Nurse Practitioner (Family)