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MR. EVAN JACOB CLARK MD
NPI 1154819951
Emergency Medicine in Mount Pleasant, WI

Active since April 26, 2018PECOS Enrolled
13250 WASHINGTON AVE, MOUNT PLEASANT, WI 53177(262) 799-8200 Get Directions Write a Review

NPPES record last updated: April 6, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 6, 2026, Apr 13, 2025, Jun 23, 2023 and 2 more (5 updates tracked since 2018).

About Mr. Evan Jacob Clark Md NPPES

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

MR. EVAN JACOB CLARK MD (NPI 1154819951) is an individual emergency medicine provider in Mount Pleasant, Wisconsin, licensed in Wisconsin (71908-20) and active in the NPI registry since April 2018. He is enrolled in Medicare PECOS and maintains a secondary practice location in Joplin.

NPPES Registry Identity

NPI1154819951
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameMR. EVAN JACOB CLARKCredential: MD
Location Address13250 WASHINGTON AVEMount Pleasant, WI 53177-1516
Mailing AddressPo Box 735044Chicago, IL 60673-5044 · (800) 326-2250
Phone(262) 799-8200
Sole ProprietorNo
Enumeration DateApril 26, 2018
Last NPPES UpdateApril 6, 20265 updates tracked since enumeration
NPPES CertifiedApril 6, 2026
✔ NPI 1154819951 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
Licenses✔ Licensed in WI · 71908-20✔ Licensed in MO · 2021019559
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
13250 WASHINGTON AVE, Mount Pleasant, WI 53177
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Secondary Practice Location 1

Location 1100 Mercy WayJoplin, MO 64804-4524 · Phone (417) 556-2300

Other Identifiers 1

Medicaid100093430WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource (Common Ground Healthcare), Medica.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)

Mr. Evan Jacob Clark Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 4

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.

Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
128 services122 patients
Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
116 services111 patients
Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
32 services32 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
22 services21 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53177 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
Most-billed visit code 99214
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.

ALEXIS MARIE VENTURA DNP, CRNA
Nurse Anesthetist, Certified Registered
13250 WASHINGTON AVE
MOUNT PLEASANT, WI 53177
Racine County (262) 857-5000
JACK CONOR NEYLON
Registered Nurse
13250 WASHINGTON AVE
MT PLEASANT, WI 53177
Racine County (262) 799-8700
DR. ADRIAN KENNETH STULL M.D.
Emergency Medicine
13250 WASHINGTON AVE
MOUNT PLEASANT, WI 53177
Racine County (262) 799-8700
JAMES M WALTENBERGER MD
Surgery
13250 WASHINGTON AVE
MOUNT PLEASANT, WI 53177
Racine County (888) 720-2012
DR. DONNA J HEMPHILL MD
Obstetrics & Gynecology
13250 WASHINGTON AVE
MOUNT PLEASANT, WI 53177
Racine County (888) 720-2012
MARGARET ANN RYNKIEWICZ
Physician Assistant
13250 WASHINGTON AVE
MOUNT PLEASANT, WI 53177
Racine County (262) 799-8700
MR. JEFFREY THOMAS VAUGHAN KROEGER CRNA
Nurse Anesthetist, Certified Registered
13250 WASHINGTON AVE
MOUNT PLEASANT, WI 53177
Racine County (262) 799-8700
MRS. SARAH KATHERINE KORDUS NP
Nurse Practitioner
13250 WASHINGTON AVE
MOUNT PLEASANT, WI 53177
Racine County (888) 720-2012

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 Evan Clark's NPI number?

The NPI number for Evan Clark is 1154819951. It was assigned to this individual provider in the NPPES registry on April 26, 2018.

Where is Evan Clark located?

Evan Clark practices at 13250 Washington Ave, Mount Pleasant, WI 53177. The listed phone number is (262) 799-8200.

What is Evan Clark's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Evan Clark enrolled in Medicare?

Yes. Evan Clark is registered in the Medicare PECOS enrollment system.

What insurance does Evan Clark accept?

Health plans from CareSource (Common Ground Healthcare) and Medica list Evan 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.

When was this NPI record last updated?

The NPPES record for Evan Clark was last updated on April 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.