JUSTINE CLARK
NPI 1770329203
Nurse Practitioner - Primary Care in Fargo, ND

Q: What is Justine Clark's NPI number?

The NPI number for Justine Clark is 1770329203. It was assigned to this individual provider in the NPPES registry on July 3, 2024.

Q: What is Justine Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Q: When was this NPI record last updated?

The NPPES record for Justine Clark was last updated on July 3, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 03, 2024PECOS EnrolledAccepts Medicare Assignment

3201 33RD ST S, FARGO, ND 58104(701) 365-4488 Get Directions Write a Review

NPPES record last updated: July 3, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Justine Clark NPPES

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

JUSTINE CLARK (NPI 1770329203) is an individual primary care provider in Fargo, North Dakota, licensed in North Dakota (200090) and active in the NPI registry since July 2024. She is enrolled in Medicare PECOS and is a graduate of University Of North Dakota School Of Medicine (2024).

NPPES Registry Identity

NPI1770329203

Entity TypeIndividualFemale

Primary Taxonomy363LP2300X

Provider Legal NameJUSTINE CLARK

Location Address3201 33RD ST SFargo, ND 58104-8823

Mailing Address2727 14th St WWest Fargo, ND 58078-8563 · (701) 793-0065

Phone(701) 365-4488

Sole ProprietorNo

Medical School CMSUniversity Of North Dakota School Of MedicineGraduated 2024

Enumeration DateJuly 3, 2024

NPPES CertifiedJuly 3, 2024

✔ NPI 1770329203 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

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

Taxonomy Code363LP2300X

License✔ Licensed in ND · 200090

3201 33RD ST S, Fargo, ND 58104

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota, Sanford Health Plan.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

Justine Clark 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 ID5991239766

PECOS Enrollment IDI20241115002196

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 58104 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

$85.71 typical visit price

range $55.75 – $168.12

Typical copayment $21.42 (range $13.93 – $42.03)

Most-billed visit code 99203

Established Patient

$98.29 typical visit price

range $18.11 – $137.65

Typical copayment $24.57 (range $4.52 – $34.41)

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.

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Other Providers at the Same Location NPPES 7

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

PAYTON PIATZ DNP, FNP

Nurse Practitioner (Family)