ELLEN MARGARET CLARK DO
NPI 1174083596
Radiology - Diagnostic Radiology in Oakland, CA
About Ellen Margaret Clark Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ELLEN MARGARET CLARK DO (NPI 1174083596) is an individual diagnostic radiology provider in Oakland, California, licensed in California (20A23964) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS and is a graduate of University Of New England, College Of Osteo Medicine (2019).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Ellen Margaret 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.
Medicare Billing Reassignment
Medicare enrollment records show Ellen Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Richmond, CA 94801
- Reassigned Medicare billing, California enrollment
- 20,078 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 94611 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Ellen Clark's NPI number?
The NPI number for Ellen Clark is 1174083596. It was assigned to this individual provider in the NPPES registry on March 21, 2019.
Where is Ellen Clark located?
Ellen Clark practices at 3600 Broadway Lowr Level, Oakland, CA 94611. The listed phone number is (510) 752-5991.
What is Ellen Clark's specialty?
The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.
Is Ellen Clark enrolled in Medicare?
Yes. Ellen 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.
Which organization bills Medicare for Ellen Clark's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ellen Clark reassigns Medicare benefits to Permanente Medical Group Inc (Richmond, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ellen Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Ellen Clark was last updated on August 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Ellen Margaret Clark, DO · NPI 1174083596
Diagnostic Radiology physician in Oakland, California. Individual provider, active in the CMS NPPES registry since March 21, 2019.
## Identity
- **NPI:** 1174083596 (Entity type: Individual)
- **Enumerated:** March 21, 2019
- **Primary specialty:** Radiology - Diagnostic Radiology · taxonomy 2085R0202X
- **State license:** 20A23964 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 3600 BROADWAY LOWR LEVEL, Oakland, CA 94611-5730
- **Phone:** (510) 752-5991
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Permanente Medical Group Inc (NPI 1235226531, Richmond, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of New England, College Of Osteo Medicine, class of 2019
## Record status
- **NPPES last updated:** August 4, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1174083596) · Data from the CMS NPPES public registry.