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DR. DWAYNE CHARLES CLARK MD
NPI 1184695975
Family Medicine in N Fond Du Lac, WI

Active since January 30, 2006PECOS EnrolledAccepts Medicare Assignment
723 PARK RIDGE LN, N FOND DU LAC, WI 54937(920) 926-8600(920) 926-8650 Get Directions Write a Review

NPPES record last updated: October 28, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 28, 2020, Feb 29, 2016, Feb 11, 2016 (3 updates tracked since 2016).

About Dr. Dwayne Charles Clark Md NPPES

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

DR. DWAYNE CHARLES CLARK MD (NPI 1184695975) is an individual family medicine provider in N Fond Du Lac, Wisconsin, licensed in Wisconsin (48855) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS and is a graduate of Duke University School Of Medicine (1994).

NPPES Registry Identity

NPI1184695975
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. DWAYNE CHARLES CLARKCredential: MD
Location Address723 PARK RIDGE LNN Fond Du Lac, WI 54937-1385
Mailing Address420 E Division StFond Du Lac, WI 54935-4560 · (920) 926-8340 · Fax (920) 926-8370
Phone(920) 926-8600
Fax(920) 926-8650
Sole ProprietorNo
Medical School CMSDuke University School Of MedicineGraduated 1994
Enumeration DateJanuary 30, 2006
Last NPPES UpdateOctober 28, 20203 updates tracked since enumeration
NPPES CertifiedOctober 28, 2020
✔ NPI 1184695975 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in WI · 48855
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
723 PARK RIDGE LN, N Fond Du Lac, WI 54937
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Other Identifiers 1

OtherP00319962WI · Railroad Medicare

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. Dwayne Charles 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 ID4284645391
PECOS Enrollment IDI20060605000046
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

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
51 services47 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54937 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.

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.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
7 suppliers21 claims54 services$5.83 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier16 claims16 services$85.51 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
3 suppliers15 claims15 services$172.63 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 12

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

DR. TEELA KOSKI PHARM.D.
Pharmacist
723 PARK RIDGE LN
NORTH FOND DU LAC, WI 54937
Fond Du Lac County (920) 926-8660
DANNY TREVOR WALKER DO
Family Medicine
723 PARK RIDGE LN
NORTH FOND DU LAC, WI 54937
Fond Du Lac County (920) 926-8600
ALEXIS LYNN MOORE FNP-C
Nurse Practitioner
723 PARK RIDGE LN
N FOND DU LAC, WI 54937
Fond Du Lac County (920) 926-8600
KARLY K BOEGEL APNP
Nurse Practitioner
723 PARK RIDGE LN
N FOND DU LAC, WI 54937
Fond Du Lac County (920) 926-8600
DOUGLAS R FOWNES MD
Family Medicine
723 PARK RIDGE LN
NORTH FOND DU LAC, WI 54937
Fond Du Lac County (920) 926-8600
DR. KUMI D SWART D.O.
Family Medicine
723 PARK RIDGE LN
N FOND DU LAC, WI 54937
Fond Du Lac County (920) 926-8600
AGNESIAN HEALTHCARE INC
Durable Medical Equipment & Medical Supplies
723 PARK RIDGE LN
N FOND DU LAC, WI 54937
Fond Du Lac County (920) 926-8600
DENISE R GATIEN BRUX NP
Nurse Practitioner (Family)
723 PARK RIDGE LN
NORTH FOND DU LAC, WI 54937
Fond Du Lac County (920) 926-8600

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 Dwayne Clark's NPI number?

The NPI number for Dwayne Clark is 1184695975. It was assigned to this individual provider in the NPPES registry on January 30, 2006.

Where is Dwayne Clark located?

Dwayne Clark practices at 723 Park Ridge Ln, N Fond Du Lac, WI 54937. The listed phone number is (920) 926-8600.

What is Dwayne Clark's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Dwayne Clark enrolled in Medicare?

Yes. Dwayne 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 Dwayne Clark was last updated on October 28, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.