Jacob Nicholas Clark, PA-C - Medicare Physician Assistant in Lansing, MI

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Jacob Nicholas Clark, PA-C is a medicare enrolled "Physician Assistant" in Lansing, Michigan. He graduated from nursing school in 2022 and has 4 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Edward W Sparrow Hospital Association and his current practice location is 1140 E Michigan Ave Ste 400, Lansing, Michigan. You can reach out to his office (for appointments etc.) via phone at (517) 364-9650.

Jacob Nicholas Clark is licensed to practice in Michigan (license number 5601011462) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1972210920.

Contact Information

Jacob Nicholas Clark, PA-C
1140 E Michigan Ave Ste 400,
Lansing, MI 48912-1806
(517) 364-9650
Not Available

Map and Direction




Provider's Profile

Full NameJacob Nicholas Clark
GenderMale
SpecialityPhysician Assistant
Experience4 Years
Location1140 E Michigan Ave Ste 400, Lansing, Michigan
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Jacob Nicholas Clark graduated from nursing school in 2022
  NPI Data:
  • NPI Number: 1972210920
  • Provider Enumeration Date: 10/31/2022
  • Last Update Date: 03/25/2026
  Medicare PECOS Information:
  • PECOS PAC ID: 7012386378
  • Enrollment ID: I20221207003090

Medical Identifiers

Medical identifiers for Jacob Nicholas Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1972210920NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant 5601011462 (Michigan)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
University Of Michigan Health-sparrow LansingLansing, MIHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Edward W Sparrow Hospital Association6709799166698

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. Jacob Nicholas Clark allows following entities to bill medicare on his behalf.
Entity NameSparrow Clinton Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1396827952
PECOS PAC ID: 5395658850
Enrollment ID: O20031111000063
Entity NameSparrow Ionia Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1700820065
PECOS PAC ID: 0042118887
Enrollment ID: O20031230000664
Entity NameEdward W Sparrow Hospital Association
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1831139088
PECOS PAC ID: 6709799166
Enrollment ID: O20040102000790
Entity NameSparrow Carson Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1598490542
PECOS PAC ID: 7113836701
Enrollment ID: O20040126000046
Entity NameSparrow Eaton Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1043419427
PECOS PAC ID: 0042103509
Enrollment ID: O20040213000368
Entity NameSparrow Eaton Hospital
Entity TypePart A Provider - Critical Access Hospital
Entity IdentifiersNPI Number: 1942254529
PECOS PAC ID: 0042103509
Enrollment ID: O20040514000807
Entity NameSparrow Ionia Hospital
Entity TypePart A Provider - Critical Access Hospital
Entity IdentifiersNPI Number: 1700820065
PECOS PAC ID: 0042118887
Enrollment ID: O20060322000295
Entity NameSparrow Clinton Hospital
Entity TypePart A Provider - Critical Access Hospital
Entity IdentifiersNPI Number: 1093809824
PECOS PAC ID: 5395658850
Enrollment ID: O20111222000366

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. Jacob Nicholas 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
Jacob Nicholas Clark, PA-C
Po Box 13008,
Lansing, MI 48901-3008

Ph: Not Available		Jacob Nicholas Clark, PA-C
1140 E Michigan Ave Ste 400,
Lansing, MI 48912-1806

Ph: (517) 364-9650

Reviews and Comments


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Jill Marie-burton Knox, PA
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Elizabeth K Labutte, PA-C
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Charles E Thomas, P.A.
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Phone: 517-267-2460    Fax: 517-267-2462
Timothy Robert Palmer, PA-C
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Practice Location: 4333 W St Joe Hwy, Lansing, MI 48917
Phone: 517-321-1525    Fax: 517-321-7059
Ms. Tiffany Louise Gose, PA-C
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Medicare: Accepting Medicare Assignments
Practice Location: 3955 Patient Care Dr Ste A, Lansing, MI 48911
Phone: 517-374-7600    Fax: 885-480-9150

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.