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SANDRA CLARK PHD
NPI 1235602293
Psychologist - Clinical in Quincy, IL

Active since January 02, 2019PECOS Enrolled
1025 MAINE ST, QUINCY, IL 62301(217) 222-6550(217) 277-2253 Get Directions Write a Review

NPPES record last updated: September 10, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 10, 2019, Aug 8, 2019, Jan 2, 2019 (3 updates tracked since 2019).

About Sandra Clark Phd NPPES

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

SANDRA CLARK PHD (NPI 1235602293) is an individual clinical provider in Quincy, Illinois, licensed in Illinois (071-009935) and active in the NPI registry since January 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1235602293
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameSANDRA CLARKCredential: PHD
Location Address1025 MAINE STQuincy, IL 62301-4096
Mailing Address1025 Maine StQuincy, IL 62301-4096 · (217) 222-6550 · Fax (217) 277-2253
Phone(217) 222-6550
Fax(217) 277-2253
Sole ProprietorNo
Enumeration DateJanuary 2, 2019
Last NPPES UpdateSeptember 10, 20193 updates tracked since enumeration
✔ NPI 1235602293 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in IL · 071-009935
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
1025 MAINE ST, Quincy, IL 62301
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sandra Clark Phd 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.

Medicare Billing Reassignment

Medicare enrollment records show Sandra Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Quincy Physicians & Surgeons Clinic, PLLC
Same address
Clinic/Center
1025 MAINE ST
Quincy, IL 62301
  • Reassigned Medicare billing, Illinois enrollment
  • 252 clinicians in this Medicare group
NPI 1548234198 (217) 222-6550

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 62301 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
$168.44 typical visit price
range $54.80 – $168.44
Typical copayment $42.11 (range $13.70 – $42.11)
Most-billed visit code 99205
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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.

WILLIAM J. HOLT M.D.
Orthopaedic Surgery
1025 MAINE ST
QUINCY, IL 62301
Adams County (217) 222-6550
NICOLE ANTOINETTE SHIELDS MS, LCPC, QMHP
Counselor (Professional)
1025 MAINE ST
QUINCY, IL 62301
Adams County (217) 222-6550
MRS. KRISTIN ELIZABETH-DANIEL THOMPSON DPT
Physical Therapist
1025 MAINE ST
QUINCY, IL 62301
Adams County (217) 222-6550
KATHLEEN JEAN NELSON M.S. ED.
Counselor (Professional)
1025 MAINE ST
QUINCY, IL 62301
Adams County (217) 222-6550
TAYLOR J. MOORE DO
Family Medicine
1025 MAINE ST
QUINCY, IL 62301
Adams County (217) 222-6550
ELIZABETH BAKER
Pharmacist
1025 MAINE ST
QUINCY, IL 62301
Adams County (217) 222-6550
DANA B ALTMAN DO
Family Medicine
1025 MAINE ST
QUINCY, IL 62301
Adams County (217) 222-6550
QUINCY PHYSICIANS & SURGEONS CLINIC, PLLC
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
1025 MAINE ST
QUINCY, IL 62301
Adams County (217) 222-6550

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 Sandra Clark's NPI number?

The NPI number for Sandra Clark is 1235602293. It was assigned to this individual provider in the NPPES registry on January 2, 2019.

Where is Sandra Clark located?

Sandra Clark practices at 1025 Maine St, Quincy, IL 62301. The listed phone number is (217) 222-6550.

What is Sandra Clark's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Sandra Clark enrolled in Medicare?

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

Which organization bills Medicare for Sandra Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sandra Clark reassigns Medicare benefits to Quincy Physicians & Surgeons Clinic, PLLC (Quincy, IL). 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 Sandra 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 Sandra Clark was last updated on September 10, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.