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DR. MARK A. CLEMENCE M.D.
NPI 1255324216
Internal Medicine in Hales Corners, WI

Active since August 25, 2005PECOS EnrolledAccepts Medicare Assignment
82.39/100
CMS Quality Rating
6080 S 108TH ST, HALES CORNERS, WI 53130(414) 425-5351(414) 529-6350 Get Directions Write a Review

NPPES record last updated: November 17, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Mark A. Clemence M.d. NPPES

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

DR. MARK A. CLEMENCE M.D. (NPI 1255324216) is an individual internal medicine provider in Hales Corners, Wisconsin, licensed in Wisconsin (34043) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Waukesha Memorial Hospital, and is a graduate of Other (1986).

NPPES Registry Identity

NPI1255324216
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. MARK A. CLEMENCECredential: M.D.
Location Address6080 S 108TH STHales Corners, WI 53130-2557
Mailing AddressPo Box 689711Milwaukee, WI 53268-9711 · (414) 456-3100 · Fax (414) 456-3113
Phone(414) 425-5351
Fax(414) 529-6350
Sole ProprietorNo
Medical School CMSOtherGraduated 1986
Enumeration DateAugust 25, 2005
Last NPPES UpdateNovember 17, 2008
✔ NPI 1255324216 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in WI · 34043
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedInternal Medicine · Infectious DiseaseTaxonomy 207RI0200X · License 34043 (WI)
6080 S 108TH ST, Hales Corners, WI 53130
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Other Identifiers 5

Other045668480WI · Medicare Ptan
Medicaid32081200WI
Other049873840WI · Medicare Ptan
Medicare ID-Type Unspecified002302475WI
Medicare UPINE70717WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Network Health.Insurance ›

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. Mark A. Clemence M.d. 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 ID648183335
PECOS Enrollment IDI20080915000406
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 9

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 moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
433 services232 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
171 services171 patients
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.
58 services45 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
19 services18 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
15 services15 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
15 services15 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Waukesha Memorial Hospital

Acute Care Hospitals · Waukesha, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520008
Location725 American AveWaukesha, WI 53188 · Waukesha County
Emergency services Birthing friendly

Ascension St Francis Hospital

Acute Care Hospitals · Milwaukee, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520078
Location3237 S 16th StMilwaukee, WI 53215 · Milwaukee County
Emergency services

Ascension SE Wisconsin Hospital

Acute Care Hospitals · Milwaukee, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520136
Location5000 W Chambers StMilwaukee, WI 53210 · Milwaukee County
Emergency services Birthing friendly

West Allis Memorial Hospital

Acute Care Hospitals · West Allis, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520139
Location8901 W Lincoln AveWest Allis, WI 53227 · Milwaukee County
Emergency services Birthing friendly

Midwest Orthopedic Specialty Hospital

Acute Care Hospitals · Franklin, WI
OwnershipPhysician
CMS Certification Number520205
Location10101 South 27th St 2nd FloorFranklin, WI 53132 · Milwaukee County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53130 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
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

82.39/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality77.88
Promoting Interoperability81
Improvement Activities40
Cost74.38

Referred Medical Equipment & Supplies CMS DME claims 5

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
11 suppliers37 claims95 services$5.16 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
8 suppliers23 claims31 services$0.98 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
5 suppliers14 claims14 services$41.36 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
5 suppliers13 claims77 services$1.44 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
3 suppliers29 claims29 services$25.92 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

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

OPHTHALMOLOGY ASSOCIATES S C
Ophthalmology
6080 S 108TH ST
HALES CORNERS, WI 53130
Milwaukee County (414) 425-9002

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 Mark Clemence's NPI number?

The NPI number for Mark Clemence is 1255324216. It was assigned to this individual provider in the NPPES registry on August 25, 2005.

Where is Mark Clemence located?

Mark Clemence practices at 6080 S 108th St, Hales Corners, WI 53130. The listed phone number is (414) 425-5351.

What is Mark Clemence's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Mark Clemence enrolled in Medicare?

Yes. Mark Clemence 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.

What insurance does Mark Clemence accept?

Health plans from Anthem Blue Cross and Blue Shield and Network Health list Mark Clemence 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.

Is Mark Clemence affiliated with any hospitals?

According to CMS data, Mark Clemence is affiliated with Waukesha Memorial Hospital, Ascension St Francis Hospital, Ascension SE Wisconsin Hospital, West Allis Memorial Hospital and Midwest Orthopedic Specialty Hospital.

When was this NPI record last updated?

The NPPES record for Mark Clemence was last updated on November 17, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.