KELLEY D. CLARK MD
NPI 1073695045
Obstetrics & Gynecology - Maternal & Fetal Medicine in York, PA

Q: What is Kelley Clark's NPI number?

The NPI number for Kelley Clark is 1073695045. It was assigned to this individual provider in the NPPES registry on October 19, 2006.

Q: What is Kelley Clark's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Maternal & Fetal Medicine, with taxonomy code 207VM0101X.

Q: When was this NPI record last updated?

The NPPES record for Kelley Clark was last updated on April 23, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since October 19, 2006PECOS EnrolledAccepts Medicare Assignment

35 MONUMENT RD STE 202, YORK, PA 17403(717) 851-2722(717) 851-3127 Get Directions Write a Review

NPPES record last updated: April 23, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 23, 2020, Jan 31, 2020, Mar 3, 2016 (3 updates tracked since 2016).

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About Kelley D. Clark Md NPPES

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

KELLEY D. CLARK MD (NPI 1073695045) is an individual maternal & fetal medicine provider in York, Pennsylvania, licensed in Pennsylvania (MD431748) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS, is affiliated with Wellspan Ephrata Community Hospital, and maintains 7 additional practice locations.

NPPES Registry Identity

NPI1073695045

Entity TypeIndividualFemale

Primary Taxonomy207VM0101X

Provider Legal NameKELLEY D. CLARKCredential: MD

Location Address35 MONUMENT RD STE 202York, PA 17403-5074

Mailing Address3421 Concord RdYork, PA 17402-9001 · (717) 851-1405 · Fax (717) 851-6969

Phone(717) 851-2722

Fax(717) 851-3127

Sole ProprietorNo

Medical School CMSKentucky School Of MedicineGraduated 1990

Enumeration DateOctober 19, 2006

Last NPPES UpdateApril 23, 20203 updates tracked since enumeration

NPPES CertifiedApril 23, 2020

✔ NPI 1073695045 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & Gynecology · Maternal & Fetal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207VM0101X

Licenses✔ Licensed in PA · MD431748✔ Licensed in KY · 30720✔ Licensed in VA · 0101259164✔ Licensed in TN · 40584

Definition

An obstetrician/gynecologist who cares for, or provides consultation on, patients with complications of pregnancy. This specialist has advanced knowledge of the obstetrical, medical and surgical complications of pregnancy and their effect on both the mother and the fetus. The specialist also possesses expertise in the most current diagnostic and treatment modalities used in the care of patients with complicated pregnancies.

35 MONUMENT RD STE 202, York, PA 17403

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Secondary Practice Locations 7

Location 11300 Hospital DriveFredericksburg, VA 22401 · Phone (540) 741-3260 · Fax (859) 260-6649

Location 222 St Paul Dr Ste 101Chambersburg, PA 17201-1036 · Phone (877) 722-1757 · Fax (717) 262-2390

Location 3450 S Washington St Ste DGettysburg, PA 17325-2500 · Phone (717) 338-3292 · Fax (717) 851-3127

Location 4175 Martin Ave Ste 105Ephrata, PA 17522-1761 · Phone (866) 244-3492 · Fax (717) 859-5637

Location 5845 Helen Dr Ste 200Lebanon, PA 17042-7493 · Phone (866) 244-3492 · Fax (717) 859-5637

Location 61001 S George StYork, PA 17403-3676 · Phone (717) 851-2722 · Fax (717) 851-3127

Location 71101 Edgar St Ste EYork, PA 17403-2862 · Phone (717) 812-4602 · Fax (717) 812-3499

Other Identifiers 1

Medicaid64307200KY

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

Kelley D. 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 ID244254746

PECOS Enrollment IDI20200504000664

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

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

Wellspan Ephrata Community Hospital

Acute Care Hospitals · Ephrata, PA

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number390225

Location169 Martin AvenueEphrata, PA 17522 · Lancaster County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 17403 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

$126.34 typical visit price

range $54.64 – $166.87

Typical copayment $31.58 (range $13.66 – $41.71)

Most-billed visit code 99204

Established Patient

$68.36 typical visit price

range $17.33 – $135.84

Typical copayment $17.09 (range $4.33 – $33.96)

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.

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Other Providers at the Same Location NPPES 11

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

SUMITHRA JEGANATHAN

Obstetrics & Gynecology (Maternal & Fetal Medicine)