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ANDREA CLARK
NPI 1992598379
Nurse Practitioner - Primary Care in Glenside, PA

Active since May 27, 2025PECOS Enrolled
721 N TYSON AVE, GLENSIDE, PA 19038(267) 921-8158 Get Directions Write a Review

NPPES record last updated: May 27, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Andrea Clark NPPES

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

ANDREA CLARK (NPI 1992598379) is an individual primary care provider in Glenside, Pennsylvania, licensed in Pennsylvania (SP032962) and active in the NPI registry since May 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1992598379
Entity TypeIndividualFemale
Primary Taxonomy363LP2300X
Provider Legal NameANDREA CLARK
Location Address721 N TYSON AVEGlenside, PA 19038-3845
Mailing Address721 N Tyson AveGlenside, PA 19038-3845 · (215) 571-9692
Phone(267) 921-8158
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateMay 27, 2025
NPPES CertifiedMay 27, 2025
✔ NPI 1992598379 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 PA · SP032962
721 N TYSON AVE, Glenside, PA 19038
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

PECOS PAC ID648775270
PECOS Enrollment IDI20250924004941
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 19038 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
$92.69 typical visit price
range $59.88 – $180.99
Typical copayment $23.17 (range $14.97 – $45.24)
Most-billed visit code 99203
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
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 Andrea Clark's NPI number?

The NPI number for Andrea Clark is 1992598379. It was assigned to this individual provider in the NPPES registry on May 27, 2025.

Where is Andrea Clark located?

Andrea Clark practices at 721 N Tyson Ave, Glenside, PA 19038. The listed phone number is (267) 921-8158.

What is Andrea Clark's specialty?

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

Is Andrea Clark enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Andrea Clark was last updated on May 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.