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SHANEEN CLARK APRN
NPI 1790216802
Nurse Practitioner - Family in Orlando, FL

Active since March 22, 2017PECOS Enrolled
7726 WINEGARD RD FL 21013, ORLANDO, FL 32809(321) 399-7353 Get Directions Write a Review

NPPES record last updated: January 24, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Shaneen Clark Aprn NPPES

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

SHANEEN CLARK APRN (NPI 1790216802) is an individual family provider in Orlando, Florida, licensed in Florida (11037260) and active in the NPI registry since March 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790216802
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSHANEEN CLARKCredential: APRN
Location Address7726 WINEGARD RD FL 21013Orlando, FL 32809-7147
Mailing Address7726 Winegard Rd Fl 21013Orlando, FL 32809-7147 · (321) 399-7353
Phone(321) 399-7353
Sole ProprietorNo
Enumeration DateMarch 22, 2017
Last NPPES UpdateJanuary 24, 2025
NPPES CertifiedJanuary 17, 2025
✔ NPI 1790216802 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in FL · 11037260
7726 WINEGARD RD FL 21013, Orlando, FL 32809
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shaneen Clark Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Shaneen Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Elyaman Medical Services PA
66 mi
Family Medicine
1720 SE 16TH AVE STE 304
Ocala, FL 34471
  • Reassigned Medicare billing, Florida enrollment
  • 39 clinicians in this Medicare group
NPI 1609251685 (352) 857-8417

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 32809 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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.

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 Shaneen Clark's NPI number?

The NPI number for Shaneen Clark is 1790216802. It was assigned to this individual provider in the NPPES registry on March 22, 2017.

Where is Shaneen Clark located?

Shaneen Clark practices at 7726 Winegard Rd Fl 21013, Orlando, FL 32809. The listed phone number is (321) 399-7353.

What is Shaneen Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Shaneen Clark enrolled in Medicare?

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

Which organization bills Medicare for Shaneen Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shaneen Clark reassigns Medicare benefits to Elyaman Medical Services PA (Ocala, FL). 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 Shaneen 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 Shaneen Clark was last updated on January 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.