DANIEL JAMES CLARK DO
NPI 1003017229
Anesthesiology in Fort Mohave, AZ


Quality Rating: 100 out of 100 score

NPI Status: Active since May 29, 2007

Contact Information

5330 S HIGHWAY 95
FORT MOHAVE, AZ
ZIP 86426
Phone: (928) 788-7115
Fax: (770) 874-5483

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  • Individual
  • Male
  • Years of Experience 16
  • Anesthesiology
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About DANIEL CLARK

Daniel Clark is an anesthesiologist established in Fort Mohave, Arizona and his medical specialization is Anesthesiology with more than 16 years of experience. The healthcare provider is registered in the NPI registry with number 1003017229 assigned on May 2007. The practitioner's primary taxonomy code is 207L00000X with license number 20A10260 (CA). The provider is registered as an individual and his NPI record was last updated 2 years ago.

NPI
1003017229
Provider Name
DANIEL JAMES CLARK DO
Gender
Male
Entity Type
Individual
Location Address
5330 S HIGHWAY 95 FORT MOHAVE, AZ 86426
Location Phone
(928) 788-7115
Location Fax
(770) 874-5483
Mailing Address
5665 NEW NORTHSIDE DR SUITE 320 ATLANTA, GA 30328
Mailing Phone
(770) 874-5400
Mailing Fax
(770) 874-5483
Medical School Name
OTHER
Graduation Year
2008
Is Sole Proprietor?
No
Enumeration Date
05-29-2007
Last Update Date
07-19-2022
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An anesthesiologist like Daniel Clark manages the care of surgical patients and pain relief through drug administration that reduces or eliminates pain during an operation, medical procedure or during labor and delivery of babies. During surgical procedures anesthesiologists are responsible for adjusting the amount of anesthetic, monitoring the patient's heart rate, body temperature, blood pressure and breathing.

Daniel Clark is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 100, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Anesthesiology

Taxonomy Code
207L00000X
Type
Allopathic & Osteopathic Physicians
License No.
20A10260
License State
CA
Taxonomy Description
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207L00000XAllopathic & Osteopathic Physicians

Anesthesiology

4708 (OK)
2207L00000XAllopathic & Osteopathic Physicians

Anesthesiology

E-5858 (AR)
3207L00000XAllopathic & Osteopathic Physicians

Anesthesiology

OP 60011959 (WA)
4207L00000XAllopathic & Osteopathic Physicians

Anesthesiology

4799 (AZ)

PECOS Enrollment and Medicare Participation Status

Daniel Clark is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 9931258159

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20201118001663

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 100 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 100

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: N/A

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Clinician Services

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.

  • 21

    Anesthesia for procedure on esophagus, stomach, and/or upper small bowel using an endoscope (HCPCS:00731)

  • 20

    Anesthesia for procedure on esophagus, stomach, small bowel, and/or large bowel using an endoscope (HCPCS:00813)

  • 17

    Ultrasonic guidance imaging supervision and interpretation for insertion of needle (HCPCS:76942)

  • 11

    Anesthesia for procedure in upper abdomen including use of an endoscope (HCPCS:00790)

Hospital Affiliations

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Daniel Clark is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
CONWAY REGIONAL HEALTH SYSTEM2302 COLLEGE AVENUE
CONWAY, AR 72034
(501) 329-3831Acute Care Hospitals
PROVIDENCE SANTA ROSA MEMORIAL HOSPITAL1165 MONTGOMERY DR
SANTA ROSA, CA 95405
(707) 525-5300Acute Care Hospitals
MEMORIAL MEDICAL CENTER1700 COFFEE RD
MODESTO, CA 95355
(209) 526-4500Acute Care Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1003017229
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003011424
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 1 + 1 + 4 + 2 + 4 + 24 = 41
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 41 = 99

The NPI number 1003017229 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1568456473 ANDRES ALVARADO M.D.
Individual
Anesthesiology5330 S HIGHWAY 95
FORT MOHAVE, AZ 86426
(928) 788-2273
1518947886DR. KENNETH DUDLEY LOCKE DO
Individual
Emergency Medicine5330 S HIGHWAY 95
FORT MOHAVE, AZ 86426
(928) 788-7069
1134142664DR. MARK E LAURSEN MD
Individual
Emergency Medicine5330 S HIGHWAY 95
FORT MOHAVE, AZ 86426
(928) 788-7064
1992992747EMERGENCY PHYSICIANS MEDICAL GROUP INC
Organization
Emergency Medicine5330 S HIGHWAY 95
FORT MOHAVE, AZ 86426
(330) 493-4443
1225205065PHC-FORT MOHAVE INC
Organization
General Acute Care Hospital5330 S HIGHWAY 95
FORT MOHAVE, AZ 86426
(928) 788-7845
1386944619EMERGENCY MEDICINE PHYSICIANS OF MOHAVE COUNTY, PLLC
Organization
Emergency Medicine5330 S HIGHWAY 95
FORT MOHAVE, AZ 86426
(928) 788-7052
1609124544ARIZONA PHYSICIAN SERVICES LLC
Organization
Anesthesiology5330 S HIGHWAY 95
FORT MOHAVE, AZ 86426
(928) 788-2273
1154758043VALLEY VIEW EMERGENCY GROUP LLC
Organization
Emergency Medicine5330 S HIGHWAY 95
FORT MOHAVE, AZ 86426
(928) 788-7115
1922262286DR. WADE GRINDLE M.D.
Individual
Anesthesiology5330 S HIGHWAY 95
FORT MOHAVE, AZ 86426
(928) 788-7090
1598157745FORT MOHAVE EMERGENCY MEDICAL ASSOCIATES INC
Organization
Emergency Medicine5330 S HIGHWAY 95
FORT MOHAVE, AZ 86426
(928) 788-2273
1962959767EM MEDICAL MANAGEMENT OF FORT MOHAVE, LLC
Organization
Emergency Medicine5330 S HIGHWAY 95
FORT MOHAVE, AZ 86426
(928) 788-7069
1952599870PHC-FORT MOHAVE INC
Organization
Medicare Defined Swing Bed Unit5330 S HIGHWAY 95
FORT MOHAVE, AZ 86426
(928) 788-2273
1316483720RADIOLOGIC ASSOCIATES OF NORTHWEST ARIZONA PLC
Organization
Radiology (Diagnostic Radiology)5330 S HIGHWAY 95
FORT MOHAVE, AZ 86426
(928) 788-7228
1124309844 PATRICK L BALLOU PA-C
Individual
Physician Assistant5330 S HIGHWAY 95
FORT MOHAVE, AZ 86426
(928) 788-7065
1649766981PHC-FORT MOHAVE INC
Organization
Medicare Defined Swing Bed Unit5330 S HIGHWAY 95
FORT MOHAVE, AZ 86426
(928) 788-2773
1265067920MS. RACHEL OTIS MLS
Individual
Specialist/Technologist, Pathology5330 S HIGHWAY 95
FORT MOHAVE, AZ 86426
(948) 788-7189
1962573436MEDSTAT ANESTHESIA CONSULTANTS
Organization
Anesthesiology5330 S HIGHWAY 95
FORT MOHAVE, AZ 86426
(928) 788-2273
1144704933 KRISTEN PEDDYCORD FNP-BC
Individual
Nurse Practitioner (Family)5330 S HIGHWAY 95
FORT MOHAVE, AZ 86426
(928) 788-2273
1770151235MRS. CARI DAWN HORNE CSFA
Individual
Specialist/Technologist, Other (Orthopedic Assistant)5330 S HIGHWAY 95
FORT MOHAVE, AZ 86426
(928) 788-2273
1316354400 NATHAN JOHN ETHRIDGE PA-C
Individual
Physician Assistant5330 S HIGHWAY 95
FORT MOHAVE, AZ 86426
(928) 788-2273

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003017229, enumerated in the NPI registry as an "individual" on May 29, 2007

The provider is located at 5330 S Highway 95 Fort Mohave, Az 86426 and the phone number is (928) 788-7115

The provider's speciality is Anesthesiology with taxonomy code 207L00000X

The provider has more than 16 years of experience.

Yes, as of May 21, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences.

The most common procedures or services performed by this practitioner are: Anesthesia for procedure on esophagus, stomach, and/or upper small bowel using an endoscope, Anesthesia for procedure on esophagus, stomach, small bowel, and/or large bowel using an endoscope, Ultrasonic guidance imaging supervision and interpretation for insertion of needle and Anesthesia for procedure in upper abdomen including use of an endoscope.

The practitioner is affiliated to the following hospital(s): CONWAY REGIONAL HEALTH SYSTEM, PROVIDENCE SANTA ROSA MEMORIAL HOSPITAL and MEMORIAL MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on May 29, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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