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COURTNEY CLARK PA-C
NPI 1740164128
Physician Assistant in New York, NY

Active since July 31, 2025PECOS Enrolled
620 COLUMBUS AVE STE 2, NEW YORK, NY 10024(212) 600-9411 Get Directions Write a Review

NPPES record last updated: August 4, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Courtney Clark Pa-c NPPES

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

COURTNEY CLARK PA-C (NPI 1740164128) is an individual physician assistant in New York, New York, licensed in New York (033995) and active in the NPI registry since July 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1740164128
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameCOURTNEY CLARKCredential: PA-C
Location Address620 COLUMBUS AVE STE 2New York, NY 10024-1459
Mailing Address660 White Plains Rd Fl Enta4Tarrytown, NY 10591-5139 · (914) 984-2552
Phone(212) 600-9411
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateJuly 31, 2025
Last NPPES UpdateAugust 4, 2025
NPPES CertifiedAugust 4, 2025
✔ NPI 1740164128 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 NY · 033995
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.
620 COLUMBUS AVE STE 2, New York, NY 10024
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Courtney Clark Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2264938109
PECOS Enrollment IDI20250930004293
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10024 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
$102.04 typical visit price
range $65.69 – $198.19
Typical copayment $25.51 (range $16.42 – $49.54)
Most-billed visit code 99203
Established Patient
$81.44 typical visit price
range $21.20 – $160.66
Typical copayment $20.36 (range $5.30 – $40.16)
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.

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.

DR. SHELI LIPSON ERSPAMER AU.D.
Audiologist
620 COLUMBUS AVE STE 2
NEW YORK, NY 10024
New York County (212) 600-9411
DR. JENNIFER TOH M.D.
Allergy & Immunology
620 COLUMBUS AVE STE 2
NEW YORK, NY 10024
New York County (212) 600-9411
KAREN F. BRODMAN, M.D., PLLC
Obstetrics & Gynecology (Gynecology)
620 COLUMBUS AVE STE 2
NEW YORK, NY 10024
New York County (212) 580-3866
TESSA VADNAIS
Physician Assistant
620 COLUMBUS AVE STE 2
NEW YORK, NY 10024
New York County (212) 600-9411
DR. KAREN F BRODMAN M.D.
Obstetrics & Gynecology (Gynecology)
620 COLUMBUS AVE STE 2
NEW YORK, NY 10024
New York County (212) 580-3866
DR. NATASHA F KEENAN M.D.
Otolaryngology
620 COLUMBUS AVE STE 2
NEW YORK, NY 10024
New York County (212) 600-9411
DR. ABIGAIL SMOLAR STERN AUD.
Audiologist
620 COLUMBUS AVE STE 2
NEW YORK, NY 10024
New York County (212) 600-9411
JOSEPH HADDAD M.D.
Otolaryngology
620 COLUMBUS AVE STE 2
NEW YORK, NY 10024
New York County (212) 600-9411

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 Courtney Clark's NPI number?

The NPI number for Courtney Clark is 1740164128. It was assigned to this individual provider in the NPPES registry on July 31, 2025.

Where is Courtney Clark located?

Courtney Clark practices at 620 Columbus Ave Ste 2, New York, NY 10024. The listed phone number is (212) 600-9411.

What is Courtney Clark's specialty?

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

Is Courtney Clark enrolled in Medicare?

Yes. Courtney Clark is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Courtney Clark was last updated on August 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.