JACOB NICHOLAS CLARK PA-C
NPI 1972210920
Physician Assistant in Lansing, MI

Q: What is Jacob Clark's NPI number?

The NPI number for Jacob Clark is 1972210920. It was assigned to this individual provider in the NPPES registry on October 31, 2022.

Q: What is Jacob Clark's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jacob Clark was last updated on March 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since October 31, 2022PECOS EnrolledAccepts Medicare Assignment

1140 E MICHIGAN AVE STE 400, LANSING, MI 48912(517) 364-9650 Get Directions Write a Review

NPPES record last updated: March 25, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 25, 2026, Jun 2, 2025, Oct 31, 2022 (3 updates tracked since 2022).

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About Jacob Nicholas Clark Pa-c NPPES

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

JACOB NICHOLAS CLARK PA-C (NPI 1972210920) is an individual physician assistant in Lansing, Michigan, licensed in Michigan (5601011462) and active in the NPI registry since October 2022. He is enrolled in Medicare PECOS, is affiliated with Edward W Sparrow Hospital, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1972210920

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameJACOB NICHOLAS CLARKCredential: PA-C

Location Address1140 E MICHIGAN AVE STE 400Lansing, MI 48912-1806

Mailing AddressPo Box 13008Lansing, MI 48901-3008

Phone(517) 364-9650

Sole ProprietorYes

Medical School CMSOtherGraduated 2022

Enumeration DateOctober 31, 2022

Last NPPES UpdateMarch 25, 20263 updates tracked since enumeration

NPPES CertifiedMarch 25, 2026

✔ NPI 1972210920 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 MI · 5601011462

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.

1140 E MICHIGAN AVE STE 400, Lansing, MI 48912

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.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

Jacob Nicholas Clark Pa-c 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 ID7012386378

PECOS Enrollment IDI20221207003090

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Edward W Sparrow Hospital

Acute Care Hospitals · Lansing, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number230230

Location1215 E Michigan AvenueLansing, MI 48912 · Ingham County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48912 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

$84.74 typical visit price

range $54.34 – $166.68

Typical copayment $21.18 (range $13.58 – $41.67)

Most-billed visit code 99203

Established Patient

$68.07 typical visit price

range $17.09 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

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 20

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

JESSICA MARY DELCORVO NP-C

Nurse Practitioner (Primary Care)