ALEXANDRA M CLARK M.D.
NPI 1770506545
Pediatrics in Loma Linda, CA
About Alexandra M Clark M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ALEXANDRA M CLARK M.D. (NPI 1770506545) is an individual pediatrics provider in Loma Linda, California, licensed in California (A74413) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Alexandra M Clark M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Alexandra Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Loma Linda, CA 92354
- Reassigned Medicare billing, California enrollment
- 2,584 clinicians in this Medicare group
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 92354 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
LOMA LINDA, CA 92354
LOMA LINDA, CA 92354
LOMA LINDA, CA 92354
LOMA LINDA, CA 92354
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 Alexandra Clark's NPI number?
The NPI number for Alexandra Clark is 1770506545. It was assigned to this individual provider in the NPPES registry on July 25, 2006.
Where is Alexandra Clark located?
Alexandra Clark practices at 11370 Anderson St Ste B-100, Loma Linda, CA 92354. The listed phone number is (909) 558-2848.
What is Alexandra Clark's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Alexandra Clark enrolled in Medicare?
Yes. Alexandra Clark is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Alexandra Clark's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Alexandra Clark reassigns Medicare benefits to Faculty Physicians And Surgeons Of Llusm (Loma Linda, CA). The 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 Alexandra Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Alexandra Clark was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Alexandra M Clark, M.D. · NPI 1770506545
Pediatrics physician in Loma Linda, California. Individual provider, active in the CMS NPPES registry since July 25, 2006.
## Identity
- **NPI:** 1770506545 (Entity type: Individual)
- **Enumerated:** July 25, 2006
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** A74413 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 11370 ANDERSON ST, STE B-100, Loma Linda, CA 92354-3450
- **Phone:** (909) 558-2848
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Faculty Physicians And Surgeons Of Llusm (NPI 1194775122, Loma Linda, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 8, 2007
- **Other identifiers:** Medicaid 00A744130 (CA); Medicare ID-Type Unspecified 00A744130; Medicare UPIN H61362
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Source: [NPI Profile](https://npiprofile.com/npi/1770506545) · Data from the CMS NPPES public registry.