DR. SUSAN CHRISTINE CLARK MD
NPI 1104096650
Surgery in Portsmouth, VA

Q: What is Susan Clark's NPI number?

The NPI number for Susan Clark is 1104096650. It was assigned to this individual provider in the NPPES registry on March 11, 2008.

Q: What is Susan Clark's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Susan Clark was last updated on February 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 March 11, 2008PECOS EnrolledAccepts Medicare Assignment

NAVAL MEDICAL CENTER PORTSMOUTH, 620 JOHN PAUL JONES CIRCLE, PORTSMOUTH, VA 23708(757) 953-9759(757) 953-0845 Get Directions Write a Review

NPPES record last updated: February 20, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 25, 2023, Mar 8, 2022 (2 updates tracked since 2022).

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About Dr. Susan Christine Clark Md NPPES

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

DR. SUSAN CHRISTINE CLARK MD (NPI 1104096650) is an individual surgery provider in Portsmouth, Virginia, licensed in Virginia (0101253279) and active in the NPI registry since March 2008. She is enrolled in Medicare PECOS, is affiliated with Northern Light Mayo Hospital, and is a graduate of Other (1999).

NPPES Registry Identity

NPI1104096650

Entity TypeIndividualFemale

Primary Taxonomy208600000X

Provider Legal NameDR. SUSAN CHRISTINE CLARKCredential: MD

Location AddressNAVAL MEDICAL CENTER PORTSMOUTH, 620 JOHN PAUL JONES CIRCLEPortsmouth, VA 23708

Mailing AddressNaval Medical Center Portsmouth, 620 John Paul Jones CirclePortsmouth, VA 23708-9971 · (757) 953-9759

Phone(757) 953-9759

Fax(757) 953-0845

Sole ProprietorYes

Medical School CMSOtherGraduated 1999

Enumeration DateMarch 11, 2008

Last NPPES UpdateFebruary 20, 20242 updates tracked since enumeration

NPPES CertifiedFebruary 16, 2024

✔ NPI 1104096650 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

Licenses✔ Licensed in VA · 0101253279✔ Licensed in NC · 2011-00718✔ Licensed in PA · MD426779

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.

NAVAL MEDICAL CENTER PORTSMOUTH, Portsmouth, VA 23708

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Other Identifiers 2

Medicaid5918139NC

Other163WHNC · Bcbsnc

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

Dr. Susan Christine 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 ID4385812080

PECOS Enrollment IDI20131008001525, I20250813000958

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 3

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

Northern Light Mayo Hospital

Critical Access Hospitals · Dover Foxcroft, ME

OwnershipGovernment - Hospital District or Authority

CMS Certification Number201309

Location897 West Main StreetDover Foxcroft, ME 04426 · Piscataquis County

Emergency services Birthing friendly

Glendive Medical Center

Critical Access Hospitals · Glendive, MT

OwnershipVoluntary non-profit - Private

CMS Certification Number271332

Location202 Prospect DrGlendive, MT 59330 · Dawson County

Emergency services

Chesapeake General Hospital

Acute Care Hospitals · Chesapeake, VA

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number490120

Location736 Battlefield Blvd, NorthChesapeake, VA 23320 · Chesapeake City County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23708 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

$86.88 typical visit price

range $56.19 – $170.30

Typical copayment $21.72 (range $14.04 – $42.57)

Most-billed visit code 99203

Established Patient

$70.08 typical visit price

range $18.07 – $138.91

Typical copayment $17.52 (range $4.51 – $34.72)

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.

TYHEISHA KRYSTAL ROACH DDS

Dentist

NAVAL MEDICAL CENTER PORTSMOUTH, 620 JOHN PAUL JONES CIRCLE
NORFOLK, VA 23708

Portsmouth City (757) 953-8591

KASTLEY MARVIN

Otolaryngology (Pediatric Otolaryngology)