Katelyn Ann Clark, MD in Springfield, OR - Medicare General Surgery

Katelyn Ann Clark, MD is a medicare enrolled "Surgery" physician in Springfield, Oregon. She went to Oregon Health Sciences University School Of Medicine and graduated in 2011 and has 13 years of diverse experience with area of expertise as General Surgery. She is a member of the group practice Peacehealth, Peacehealth Medical Group and her current practice location is Peacehealth Surgical Specialties, 3355 Riverbend Dr., Suite 300, Springfield, Oregon. You can reach out to her office (for appointments etc.) via phone at (541) 222-8333.

Katelyn Ann Clark is licensed to practice in Oregon (license number MD175116) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1366732729.

Contact Information

	Katelyn Ann Clark, MD
	Peacehealth Surgical Specialties, 3355 Riverbend Dr., Suite 300, Springfield, OR 97477
	(541) 222-8333
	(541) 222-8320

Map and Direction

Physician's Profile

Full Name	Katelyn Ann Clark
Gender	Female
Speciality	General Surgery
Experience	13 Years
Location	Peacehealth Surgical Specialties, Springfield, Oregon
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Katelyn Ann Clark attended and graduated from Oregon Health Sciences University School Of Medicine in 2011

NPI Data:

NPI Number: 1366732729
Provider Enumeration Date: 04/19/2011
Last Update Date: 02/28/2024

Medicare PECOS Information:

PECOS PAC ID: 7911143201
Enrollment ID: I20160727000078

Medical Identifiers

Medical identifiers for Katelyn Ann Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1366732729	NPI	-	NPPES
500654943	Medicaid	OR

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208600000X	Surgery	MD175116 (Oregon)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Sacred Heart Medical Center - Riverbend	Springfield, OR	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Peacehealth	8527016039	174
Peacehealth Medical Group	9032023270	206

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. Katelyn Ann Clark allows following entities to bill medicare on her behalf.

Entity Name	Peacehealth Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1447207287 PECOS PAC ID: 9032023270 Enrollment ID: O20031113000097

Entity Name	Northwest Surgical Specialists Llp
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1770516544 PECOS PAC ID: 9032009493 Enrollment ID: O20040318000836

Entity Name	Peacehealth
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1740223874 PECOS PAC ID: 8527016039 Enrollment ID: O20050111000353

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. Katelyn Ann 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 Address	Practice Location Address
Katelyn Ann Clark, MD Peacehealth Surgical Specialties, 3355 Riverbend Dr., Suite 300, Springfield, OR 97477 Ph: (541) 222-8333	Katelyn Ann Clark, MD Peacehealth Surgical Specialties, 3355 Riverbend Dr., Suite 300, Springfield, OR 97477 Ph: (541) 222-8333

Reviews and Comments

Surgery Doctors in Springfield, OR

Dr. Jose Viramontes Jr., M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1460 G St Ste 100, Springfield, OR 97477 Phone: 541-988-6330 Fax: 541-988-6340
Dr. Snell Fontus, MD Surgery Medicare: Medicare Enrolled Practice Location: 1881 2nd St, Ste 201, Springfield, OR 97477 Phone: 541-684-4716 Fax: 541-683-9790
Dr. Paul S. Koh, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 3311 Riverbend Drive, Springfield, OR 97477 Phone: 541-222-2866 Fax: 541-222-2843
Daniel A Cusati, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: Peacehealth Surgical Specialties, 3355 Riverbend Dr., Suite 300, Springfield, OR 97477 Phone: 541-222-8333 Fax: 541-222-8320
Dr. Warren M Glover, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 3311 Riverbend Dr, Springfield, OR 97477 Phone: 541-222-3531 Fax: 541-222-2843
Winnie W. Henderson, M.D., PH.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 3783 International Ct Ste 200, Springfield, OR 97477 Phone: 541-735-3778 Fax: 541-735-3772
Nichole Ingalls, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: Peacehealth Surgical Specialties, 3355 Riverbend Dr Ste 300, Springfield, OR 97477 Phone: 541-222-8333 Fax: 541-222-8320

Katelyn Ann Clark, MD - Medicare General Surgery in Springfield, OR