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CLANCY J CLARK MD
NPI 1053455444
Surgery in Seattle, WA

Active since February 18, 2007PECOS EnrolledAccepts Medicare Assignment
1100 9TH AVE, SEATTLE, WA 98101(206) 624-1144 Get Directions Write a Review

NPPES record last updated: December 13, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 13, 2024, Dec 3, 2024 (2 updates tracked since 2024).

About Clancy J Clark Md NPPES

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

CLANCY J CLARK MD (NPI 1053455444) is an individual surgery provider in Seattle, Washington, licensed in Washington (MD61617432) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS, is affiliated with North Carolina Baptist Hospital, and maintains a secondary practice location in Winston Salem.

NPPES Registry Identity

NPI1053455444
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameCLANCY J CLARKCredential: MD
Location Address1100 9TH AVESeattle, WA 98101
Mailing Address2450 Greenbrier RdWinston Salem, NC 27104-2108 · (336) 480-8064
Phone(206) 624-1144
Sole ProprietorNo
Medical School CMSOhio State University College Of MedicineGraduated 2004
Enumeration DateFebruary 18, 2007
Last NPPES UpdateDecember 13, 20242 updates tracked since enumeration
NPPES CertifiedDecember 13, 2024
✔ NPI 1053455444 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Licenses✔ Licensed in WA · MD61617432✔ Licensed in NC · 2012-01216
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Also ListedSurgery · Surgical OncologyTaxonomy 2086X0206X · License 2012-01216 (NC)
1100 9TH AVE, Seattle, WA 98101
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Secondary Practice Location 1

Location 1Medical Center BlvdWinston Salem, NC 27157-0001 · Phone (336) 716-9272 · Fax (336) 716-6637

Other Identifiers 1

Medicaid5920754NC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Clancy J Clark Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3870627979
PECOS Enrollment IDI20241204001807
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.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
144 services98 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
27 services27 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
16 services15 patients
Telephone medical discussion with physician, 11-20 minutes 99442
This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.
16 services16 patients
Ultrasonic guidance during surgery 76998
Ultrasonic guidance during surgery is a technique that uses sound waves to create real-time images of the inside of your body. This helps the surgeon navigate and perform procedures more accurately, reducing the risk of complications. It's like a GPS for your body's internal structures.
13 services13 patients

Hospital Affiliations CMS Care Compare 5

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

North Carolina Baptist Hospital

Acute Care Hospitals · Winston-Salem, NC
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340047
LocationMedical Center BoulevardWinston-Salem, NC 27157 · Forsyth County
Emergency services Birthing friendly

Virginia Mason Medical Center

Acute Care Hospitals · Seattle, WA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number500005
Location925 Seneca StSeattle, WA 98101 · King County
Emergency services Birthing friendly

St Clare Hospital

Acute Care Hospitals · Lakewood, WA
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number500021
Location11315 Bridgeport Way S WLakewood, WA 98499 · Pierce County
Emergency services

Harrison Medical Center

Acute Care Hospitals · Bremerton, WA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number500039
Location2520 Cherry AvenueBremerton, WA 98310 · Kitsap County
Emergency services Birthing friendly

St Joseph Medical Center

Acute Care Hospitals · Tacoma, WA
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number500108
Location1717 South J StreetTacoma, WA 98405 · Pierce County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98101 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
$97.43 typical visit price
range $63.67 – $189.37
Typical copayment $24.35 (range $15.91 – $47.34)
Most-billed visit code 99203
Established Patient
$78.74 typical visit price
range $21.12 – $155.00
Typical copayment $19.68 (range $5.28 – $38.75)
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.

Other Providers at the Same Location NPPES 20

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

JACLYN ANN SUBKOVIAK OT
Occupational Therapist
1100 9TH AVE
SEATTLE, WA 98101
King County (206) 341-0461
MARCIE G HUME PHARM.D.
Pharmacist
1100 9TH AVE, MS C3-PO
SEATTLE, WA 98101
King County (206) 223-6877
DR. VINAY GUPTA MD
Internal Medicine (Critical Care Medicine)
1100 9TH AVE
SEATTLE, WA 98101
King County (206) 223-6980
MARY JO BUKOVIC CCP
Contractor
1100 9TH AVE
SEATTLE, WA 98101
King County (206) 223-6600
PEGAH SAFAEIAN D.O.
Physical Medicine & Rehabilitation
1100 9TH AVE
SEATTLE, WA 98101
King County (206) 223-6600
MRS. GENEVIEVE HOUDET-COTE SLP
Speech-Language Pathologist
1100 9TH AVE, MS:H4-PMR
SEATTLE, WA 98101
King County (206) 341-0461
ROBERT DALE MCCLURE MD
Surgery
1100 9TH AVE
SEATTLE, WA 98101
King County (206) 223-6600
VIRGINIA MASON MEDICAL CENTER
Internal Medicine (Gastroenterology)
1100 9TH AVE
SEATTLE, WA 98101
King County (206) 223-6600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Clancy Clark's NPI number?

The NPI number for Clancy Clark is 1053455444. It was assigned to this individual provider in the NPPES registry on February 18, 2007.

Where is Clancy Clark located?

Clancy Clark practices at 1100 9th Ave, Seattle, WA 98101. The listed phone number is (206) 624-1144.

What is Clancy Clark's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Clancy Clark enrolled in Medicare?

Yes. Clancy Clark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Clancy Clark accept?

Health plans from AmeriHealth Caritas Next, Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Clancy Clark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Clancy Clark affiliated with any hospitals?

According to CMS data, Clancy Clark is affiliated with North Carolina Baptist Hospital, Virginia Mason Medical Center, St Clare Hospital, Harrison Medical Center and St Joseph Medical Center.

When was this NPI record last updated?

The NPPES record for Clancy Clark was last updated on December 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.