RICK C. CLARK JR. PA
NPI 1033190533
Physician Assistant in Malad City, ID

Q: What is Rick Clark's NPI number?

The NPI number for Rick Clark is 1033190533. It was assigned to this individual provider in the NPPES registry on November 10, 2005.

Q: What is Rick Clark's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Rick Clark was last updated on November 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 10, 2005PECOS Enrolled

220 BANNOCK ST, SUITE 306, MALAD CITY, ID 83252(208) 766-2600(208) 766-4258 Get Directions Write a Review

NPPES record last updated: November 16, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Rick C. Clark Jr. Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RICK C. CLARK JR. PA (NPI 1033190533) is an individual physician assistant in Malad City, Idaho, licensed in Idaho (PA-749) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with Portneuf Medical Center, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1033190533

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameRICK C. CLARK JR.Credential: PA

Location Address220 BANNOCK ST, SUITE 306Malad City, ID 83252-1256

Mailing AddressPo Box 126, Suite 306Malad City, ID 83252-0126 · (208) 766-2231 · Fax (208) 766-4819

Phone(208) 766-2600

Fax(208) 766-4258

Sole ProprietorNo

Medical School CMSOtherGraduated 2000

Enumeration DateNovember 10, 2005

Last NPPES UpdateNovember 16, 2021

NPPES CertifiedNovember 16, 2021

✔ NPI 1033190533 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in ID · PA-749

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

220 BANNOCK ST, Malad City, ID 83252

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Rick C. Clark Jr. Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6800038324

PECOS Enrollment IDI20260123003368

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Portneuf Medical Center

Acute Care Hospitals · Pocatello, ID

4/5 CMS rating

OwnershipProprietary

CMS Certification Number130028

Location777 Hospital WayPocatello, ID 83201 · Bannock County

Emergency services Birthing friendly

Nell J Redfield Memorial Hospital

Critical Access Hospitals · Malad, ID

OwnershipGovernment - Local

CMS Certification Number131303

Location150 North 200 WestMalad, ID 83252 · Oneida County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83252 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$65.77 typical visit price

range $16.68 – $130.93

Typical copayment $16.44 (range $4.17 – $32.73)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

1 supplier19 claims19 services$8.06 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

3 suppliers87 claims87 services$115.70 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

1 supplier16 claims746 services$0.08 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MEL BINGHAM PA-C

Physician Assistant