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JONATHAN ANDREW CLARK APRN
NPI 1790246270
Nurse Practitioner - Family in St Petersburg, FL

Active since March 27, 2019PECOS EnrolledAccepts Medicare Assignment
5042 12TH AVE N, ST PETERSBURG, FL 33710(727) 631-2091 Get Directions Write a Review

NPPES record last updated: March 27, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jonathan Andrew Clark Aprn NPPES

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

JONATHAN ANDREW CLARK APRN (NPI 1790246270) is an individual family provider in St Petersburg, Florida, licensed in Florida (11000850) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1790246270
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameJONATHAN ANDREW CLARKCredential: APRN
Location Address5042 12TH AVE NSt Petersburg, FL 33710-6011
Mailing Address5042 12th Ave NSt Petersburg, FL 33710-6011 · (727) 631-2091
Phone(727) 631-2091
Sole ProprietorYes
Medical School CMSOtherGraduated 2018
Enumeration DateMarch 27, 2019
✔ NPI 1790246270 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 · 11000850
5042 12TH AVE N, St Petersburg, FL 33710
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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 and accepts Medicare assignment

Jonathan Andrew Clark Aprn 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 ID6507199890
PECOS Enrollment IDI20190530002427
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 33710 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 Jonathan Clark's NPI number?

The NPI number for Jonathan Clark is 1790246270. It was assigned to this individual provider in the NPPES registry on March 27, 2019.

Where is Jonathan Clark located?

Jonathan Clark practices at 5042 12th Ave N, St Petersburg, FL 33710. The listed phone number is (727) 631-2091.

What is Jonathan Clark's specialty?

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

Is Jonathan Clark enrolled in Medicare?

Yes. Jonathan Clark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jonathan Clark was last updated on March 27, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.