Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kristen J. Clark, PA

Individual provider Physician Assistant · NPI 1578527545

Kristen J. Clark, PA is a Physician Assistant in Winter Park, Florida. Qualified in 2005, 21 years ago. Practices with The Ear Nose and Throat Surgical Associates PA, a 50-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
21
Licensed in
GA
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

133 Benmore Dr Ste 100
Winter Park, FL 32792-4111
Phone: (407) 644-4483
Fax: (407) 644-3697
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 004548 (GA)

Record details

NPI number1578527545
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedApril 14, 2006
Last updated in NPPESNovember 20, 2024
Certification dateNovember 20, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice The Ear Nose And Throat Surgical Associates Pa — 50 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in Winter Park