JENNIFER CLARK (P. A.) – Surgical Physician Assistant, NPI 1114479052

JENNIFER CLARK (P. A.) is a healthcare provider. based in Downers grove, Illinois. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials P. A.. The NPI Number for JENNIFER CLARK (P. A.) is 1114479052

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
JENNIFER CLARK (P. A.)
NPI
1114479052
Phone
(630) 323-6116
Address
2138 PRENTISS DR
Enumeration Date
26 October 2016
Last Update Date
26 October 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8157178730
Graduation Year
2016 (10 years ago)
PAC ID
9032490917
Group Practice PAC ID
0042358673
Professional Enrollment ID
I20170109001122
Address ID
IL604519547NE1890XBLVD401
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:9State licenses:0Digital endpointsOther names

5,035 PHYSICIAN ASSISTANT in IL

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Provider Addresses for JENNIFER CLARK (P. A.)

  • 2138, Prentiss Drive, Prentiss Creek, Downers Grove, DuPage County, Illinois, 60516, United States

    DOWNERS GROVE, IL 605165314

    Phone: (630) 323-6116

    Fax: (630) 794-8620

    Type: Mailing

  • 550, West Ogden Avenue, Hinsdale, DuPage County, Illinois, 60521, United States

    HINSDALE, IL 605213186

    Phone: (630) 323-6116

    Fax: (630) 794-8620

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 131 Open Payments records for all available years, with a total value of $2,800.

Total Amount is formed as General ($2,800) + Research ($0) + Ownership ($0) = $2,800.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Davol Inc. ($881).

Total Amount

$2,800

General + Research + Ownership

Payments

131

Total payment records

General Amount

$2,800

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-01-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170109001122IPhysician AssistantILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes9479$0
99214Established patient office or other outpatient visit, 30-39 minutes8378$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes5635$0
49650Repair of groin hernia using an endoscope3434$0
47563Removal of gallbladder with x-ray study of bile ducts using an endoscope2424$0
View full utilization report →

Insurance plans in this area (ZIP 60516)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0042358673View full group profile
NameSpecialtyState
General SurgeryIL
Physician AssistantIL
General Surgery, Colorectal Surgery (Proctology), Hematology/OncologyIL
General SurgeryIL
-CA
General SurgeryIL
General SurgeryIL
Physician AssistantNV
General SurgeryIL

Reviews

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Frequently asked questions

Is JENNIFER CLARK (P. A.) listed with a National Provider Identifier?
Yes — JENNIFER CLARK (P. A.) has NPI 1114479052 on file in the registry.
Is JENNIFER CLARK (P. A.) still an active registrant?
JENNIFER CLARK (P. A.) carries an active NPI according to the public dataset.
How would a patient describe JENNIFER CLARK (P. A.)'s focus?
For JENNIFER CLARK (P. A.), the primary taxonomy reads as Surgical Physician Assistant. Clinical services aligned with this taxonomy classification.
Is JENNIFER CLARK (P. A.) associated with Downers Grove?
Public fields place JENNIFER CLARK (P. A.) around Downers Grove, Illinois. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for JENNIFER CLARK (P. A.) is noted as October 26, 2016 where the registry provides it.

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