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DR. MICHAEL ELLSWORTH CLARKE DDS MS
NPI 1316908296
Oral & Maxillofacial Surgery in Wailuku, HI

Active since March 30, 2006Opted out of Medicare · through Aug 16, 2026
24 N CHURCH ST, #206, WAILUKU, HI 96795(808) 242-0077(808) 243-8007 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Michael Ellsworth Clarke Dds Ms NPPES

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

DR. MICHAEL ELLSWORTH CLARKE DDS MS (NPI 1316908296) is an individual oral & maxillofacial surgery provider in Wailuku, Hawaii, licensed in Hawaii (DT1439) and active in the NPI registry since March 2006. He has opted out of Medicare through August 16, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1316908296
Entity TypeIndividualMale
Primary Taxonomy204E00000X
Provider Legal NameDR. MICHAEL ELLSWORTH CLARKECredential: DDS MS
Location Address24 N CHURCH ST, #206Wailuku, HI 96795
Mailing Address24 N Church St, #206Wailuku, HI 96795 · (808) 242-0077 · Fax (808) 243-8007
Phone(808) 242-0077
Fax(808) 243-8007
Sole ProprietorNo
Enumeration DateMarch 30, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1316908296 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
License✔ Licensed in HI · DT1439
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
24 N CHURCH ST, Wailuku, HI 96795
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Other Identifiers 4

Other1439HI · Hds
Medicaid52622001HI
Medicare UPINT95540
OtherB059978Hmsa

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Michael Ellsworth Clarke Dds Ms has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from August 16, 2018 through August 16, 2026.

Opt-Out Effective DateAugust 16, 2018
Opt-Out In Effect ThroughAugust 16, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

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 Michael Clarke's NPI number?

The NPI number for Michael Clarke is 1316908296. It was assigned to this individual provider in the NPPES registry on March 30, 2006.

Where is Michael Clarke located?

Michael Clarke practices at 24 N Church St #206, Wailuku, HI 96795. The listed phone number is (808) 242-0077.

What is Michael Clarke's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Michael Clarke enrolled in Medicare?

No. Michael Clarke has opted out of Medicare through August 16, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Michael Clarke was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.