Jonathan Andrew Clark, APRN - Medicare Nurse Practitioner in St Petersburg, FL

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Jonathan Andrew Clark, APRN is a medicare enrolled "Nurse Practitioner - Family" in St Petersburg, Florida. His current practice location is 5042 12th Ave N, St Petersburg, Florida. You can reach out to his office (for appointments etc.) via phone at (727) 631-2091.

Jonathan Andrew Clark is licensed to practice in Florida (license number 11000850) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1790246270.

Contact Information

Jonathan Andrew Clark, APRN
5042 12th Ave N,
St Petersburg, FL 33710-6011
(727) 631-2091
Not Available

Map and Direction




Provider's Profile

Full NameJonathan Andrew Clark
GenderMale
SpecialityNurse Practitioner - Family
Location5042 12th Ave N, St Petersburg, Florida
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1790246270
  • Provider Enumeration Date: 03/27/2019
  • Last Update Date: 03/27/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 6507199890
  • Enrollment ID: I20190530002427

Medical Identifiers

Medical identifiers for Jonathan Andrew Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1790246270NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 11000850 (Florida)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jonathan Andrew Clark allows following entities to bill medicare on his behalf.
Entity NameFlorida Wound Care Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1770718561
PECOS PAC ID: 3072669613
Enrollment ID: O20090923000068
Entity NameEpisource Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1225390289
PECOS PAC ID: 7911009451
Enrollment ID: O20200515002219

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jonathan Andrew Clark is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jonathan Andrew Clark, APRN
5042 12th Ave N,
St Petersburg, FL 33710-6011

Ph: (727) 631-2091		Jonathan Andrew Clark, APRN
5042 12th Ave N,
St Petersburg, FL 33710-6011

Ph: (727) 631-2091

Reviews and Comments


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Mrs. Shanna Ann Sherman, ARNP
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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.