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

Nicholas McKinley Clark, PA-C

Individual provider Physician Assistant · NPI 1679367288

Nicholas McKinley Clark, PA-C is a Physician Assistant in Phoenix, Arizona. Qualified in 2024, 2 years ago. Practices with Circle the City, a 63-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
2
Licensed in
AZ
In the registry since
2025
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3522 N 3rd Ave
Phoenix, AZ 85013-3903
Phone: (602) 776-7676
Fax: (602) 705-0567
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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 11035 (AZ)

Record details

NPI number1679367288
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 8, 2025
Last updated in NPPESApril 24, 2026
Certification dateApril 24, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Circle The City — 63 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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