ELLEN MARGARET CLARK DO
NPI 1174083596
Radiology - Diagnostic Radiology in Oakland, CA

Q: 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.

Q: What is Ellen Clark's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Q: 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 12 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.

Active since March 21, 2019PECOS EnrolledAccepts Medicare Assignment

3600 BROADWAY LOWR LEVEL, OAKLAND, CA 94611(510) 752-5991 Get Directions Write a Review

NPPES record last updated: August 4, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 4, 2025, Mar 21, 2019 (2 updates tracked since 2019).

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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

NPI1174083596

Entity TypeIndividualFemale

Primary Taxonomy2085R0202X

Provider Legal NameELLEN MARGARET CLARKCredential: DO

Location Address3600 BROADWAY LOWR LEVELOakland, CA 94611-5730

Mailing Address3600 Broadway Lowr LevelOakland, CA 94611-5730

Phone(510) 752-5991

Sole ProprietorNo

Medical School CMSUniversity Of New England, College Of Osteo MedicineGraduated 2019

Enumeration DateMarch 21, 2019

Last NPPES UpdateAugust 4, 20252 updates tracked since enumeration

NPPES CertifiedAugust 4, 2025

✔ NPI 1174083596 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0202X

License✔ Licensed in CA · 20A23964

Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Also ListedRadiology · Pediatric RadiologyTaxonomy 2085P0229X · License 20A23964 (CA)

3600 BROADWAY LOWR LEVEL, Oakland, CA 94611

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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

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.

PECOS PAC ID8820326028

PECOS Enrollment IDI20250728000384

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.

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.

New Patient

$104.51 typical visit price

range $69.00 – $202.35

Typical copayment $26.12 (range $17.25 – $50.58)

Most-billed visit code 99203

Established Patient

$84.91 typical visit price

range $23.44 – $166.46

Typical copayment $21.22 (range $5.86 – $41.61)

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.

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.

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 12 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.