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KELLAN FITZGERALD CLARK DO
NPI 1134539091
Urology in Hamilton, MT

Active since April 30, 2014PECOS EnrolledAccepts Medicare Assignment
1200 WESTWOOD DR STE F, HAMILTON, MT 59840(406) 375-2930(406) 375-4525 Get Directions Write a Review

NPPES record last updated: November 12, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 12, 2024, May 12, 2021, Jan 23, 2020 and 1 more (4 updates tracked since 2019).

About Kellan Fitzgerald Clark Do NPPES

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

KELLAN FITZGERALD CLARK DO (NPI 1134539091) is an individual urology provider in Hamilton, Montana, licensed in Montana (MED-PHYS-LIC-71931) and active in the NPI registry since April 2014. He is enrolled in Medicare PECOS, is affiliated with St. Patrick Hospital, and is a graduate of Edward Via Col Of Osteo Medicine-carolinas Campus (2014).

NPPES Registry Identity

NPI1134539091
Entity TypeIndividualMale
Primary Taxonomy208800000X
Provider Legal NameKELLAN FITZGERALD CLARKCredential: DO
Location Address1200 WESTWOOD DR STE FHamilton, MT 59840-2345
Mailing Address1200 Westwood DrHamilton, MT 59840-2345
Phone(406) 375-2930
Fax(406) 375-4525
Sole ProprietorNo
Medical School CMSEdward Via Col Of Osteo Medicine-carolinas CampusGraduated 2014
Enumeration DateApril 30, 2014
Last NPPES UpdateNovember 12, 20244 updates tracked since enumeration
NPPES CertifiedNovember 12, 2024
✔ NPI 1134539091 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
License✔ Licensed in MT · MED-PHYS-LIC-71931
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
1200 WESTWOOD DR STE F, Hamilton, MT 59840
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Other Identifiers 2

Medicaid1134539091ID
Medicaid100004016MT

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Mountain Health CO-OP, 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

Kellan Fitzgerald Clark Do 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 ID1850642497
PECOS Enrollment IDI20191016000294
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.

St. Patrick Hospital

Acute Care Hospitals · Missoula, MT
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number270014
Location500 W BroadwayMissoula, MT 59806 · Missoula County
Emergency services Birthing friendly

Community Medical Center

Acute Care Hospitals · Missoula, MT
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number270023
Location2827 Fort Missoula RdMissoula, MT 59804 · Missoula County
Emergency services Birthing friendly

Bitterroot Health - Daly Hospital

Critical Access Hospitals · Hamilton, MT
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number271340
Location1200 Westwood DrHamilton, MT 59840 · Ravalli County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 59840 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
$130.52 typical visit price
range $56.81 – $172.26
Typical copayment $32.63 (range $14.20 – $43.06)
Most-billed visit code 99204
Established Patient
$70.82 typical visit price
range $18.24 – $140.32
Typical copayment $17.70 (range $4.56 – $35.08)
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.

Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) A4314
DME-Orthotic Devices · category DF000N
2 suppliers13 claims24 services$22.26 avg. paid by Medicare
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351
DME-Orthotic Devices · category DF008N
5 suppliers86 claims11,432 services$1.39 avg. paid by Medicare
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each A4352
DME-Orthotic Devices · category DF008N
2 suppliers80 claims9,310 services$4.94 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 4

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

MARCUS DALY MEMORIAL HOSPITAL CORP
Surgery
1200 WESTWOOD DR STE F
HAMILTON, MT 59840
Ravalli County (406) 375-2930
LUKE T CHANNER M.D.
Surgery
1200 WESTWOOD DR STE F
HAMILTON, MT 59840
Ravalli County (406) 375-2930
ALICIA MICHELE WILLIAMS PA-C
Physician Assistant
1200 WESTWOOD DR STE F
HAMILTON, MT 59840
Ravalli County (406) 375-4868
DR. JOSHUA ROBERT WAGGENER MD
Surgery
1200 WESTWOOD DR STE F
HAMILTON, MT 59840
Ravalli County (406) 375-2930

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 Kellan Clark's NPI number?

The NPI number for Kellan Clark is 1134539091. It was assigned to this individual provider in the NPPES registry on April 30, 2014.

Where is Kellan Clark located?

Kellan Clark practices at 1200 Westwood Dr Ste F, Hamilton, MT 59840. The listed phone number is (406) 375-2930.

What is Kellan Clark's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Kellan Clark enrolled in Medicare?

Yes. Kellan 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 Kellan Clark accept?

Health plans from Blue Cross and Blue Shield of Montana, Mountain Health CO-OP and Providence Health Plan list Kellan 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 Kellan Clark affiliated with any hospitals?

According to CMS data, Kellan Clark is affiliated with St. Patrick Hospital, Community Medical Center and Bitterroot Health - Daly Hospital.

When was this NPI record last updated?

The NPPES record for Kellan Clark was last updated on November 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.