Doctor profile · Federal record
Dr. KOLU BAYSAH CLARK, DNP
Gerontology Nurse Practitioner (CMS: NURSE PRACTITIONER) · Nurse Practitioner · Primary Care Nurse Practitioner · Primary Care Nurse Practitioner · WARWICK, RI
- NPI 1336535624
- Accepts Medicare
- 9 yrs in practice
- Licensed in 2 states
- Female
- Group practice
- No sanctions
Practice & contact
Operates at 3 locations .
- Primary practice
-
455 TOLL GATE RD
WARWICK, RI 028862759
(401) 737-7010 - Additional location
-
1 Harvard Rd
Shirley, MA 014642434
(978) 425-4341 - Additional location
-
55 Lake Ave N
Worcester, MA 016550002
(508) 334-8515
fax (508) 334-6490 - Mailing address
-
455 TOLLGATE RD, PROFESSIONAL REVENUE CYCLE AND CREDENTIALING
WARWICK, RI 028862759
Credentials & registration
- NPI registered
- April 2015 — 11 yrs on file
- Profile last updated
- December 21, 2021
- Year of graduation
- 2017 — 9 yrs since
- Specialty taxonomy
- 363LG0600X — NUCC code
- State licenses (2)
- Rhode Island #APRN00086 · Massachusetts #RN2269378
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1336535624. Last verified May 11, 2026.Medicare procedures · 2023
Top services delivered
Total services
13
Distinct HCPCS
1
Medicare allowed
$1,883
| HCPCS | Description | Services | Patients | Avg allowed | |
|---|---|---|---|---|---|
99223 |
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 13 | 13 | $145 |
In context: peer comparison
Among 2 peers in this city , average services per provider: 170. This provider delivers 0.1× the peer median.