Mrs Katherine Rose Clark, PA-C in Crystal, MN - Medicare Physician Assistant

Mrs Katherine Rose Clark, PA-C is a medicare enrolled "Physician Assistant" in Crystal, Minnesota. She went to Touro Un Col Of Osteopathic Medicine, Henderson and graduated in 2023 and has 2 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice North Clinic Pa and her current practice location is 5109 36th Ave N, Crystal, Minnesota. You can reach out to her office (for appointments etc.) via phone at (763) 587-7999.

Mrs Katherine Rose Clark is licensed to practice in Minnesota (license number 14744) 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 1003683509.

Contact Information

	Mrs Katherine Rose Clark, PA-C
	5109 36th Ave N, Crystal, MN 55422
	(763) 587-7999
	(763) 587-7989

Map and Direction

Provider's Profile

Full Name	Mrs Katherine Rose Clark
Gender	Female
Speciality	Physician Assistant
Experience	2 Years
Location	5109 36th Ave N, Crystal, Minnesota
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:

Mrs Katherine Rose Clark attended and graduated from Touro Un Col Of Osteopathic Medicine, Henderson in 2023

NPI Data:

NPI Number: 1003683509
Provider Enumeration Date: 12/05/2023
Last Update Date: 03/31/2025

Medicare PECOS Information:

PECOS PAC ID: 1759732951
Enrollment ID: I20240112000539

Medical Identifiers

Medical identifiers for Mrs Katherine Rose Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1003683509	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363A00000X	Physician Assistant	14744 (Minnesota)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
North Clinic Pa	2769384205	47

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. Mrs Katherine Rose 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
Mrs Katherine Rose Clark, PA-C 5109 36th Ave N, Crystal, MN 55422 Ph: (763) 587-7999	Mrs Katherine Rose Clark, PA-C 5109 36th Ave N, Crystal, MN 55422 Ph: (763) 587-7999

Reviews and Comments

Physician Assistant Nurses in Crystal, MN

Stephanie Albrecht Lee, PHYSICIAN ASSISTANT Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5700 Bottineau Blvd Ste 100, Crystal, MN 55429 Phone: 763-504-6500
Mrs. Katherine Mccourt Robinson Larson, PA C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4725 36th Ave N, Crystal, MN 55422 Phone: 218-208-2058
Sara Lynn Budhoo, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5700 Bottineau Blvd, Crystal, MN 55429 Phone: 763-504-6550
Lisa Lapointe, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5109 36th Ave N, Crystal, MN 55422 Phone: 763-587-7900 Fax: 763-587-7989
Mary E Broughton, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5109 36th Ave N, Crystal, MN 55422 Phone: 763-587-7900 Fax: 763-587-7989
Lisa Legvold, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4725 36th Ave N, Crystal, MN 55422 Phone: 218-208-2058

Mrs Katherine Rose Clark, PA-C - Medicare Physician Assistant in Crystal, MN