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KATELYN ANN CLARK M.D.
NPI 1366732729
Surgery in Springfield, OR

Active since April 19, 2011PECOS EnrolledAccepts Medicare Assignment
PEACEHEALTH SURGICAL SPECIALTIES, 3355 RIVERBEND DR., SUITE 300, SPRINGFIELD, OR 97477(541) 222-8333(541) 222-8320 Get Directions Write a Review

NPPES record last updated: February 28, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 29, 2022, Dec 6, 2021, Feb 13, 2020 and 4 more (7 updates tracked since 2016).

About Katelyn Ann Clark M.d. NPPES

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

KATELYN ANN CLARK M.D. (NPI 1366732729) is an individual surgery provider in Springfield, Oregon, licensed in Oregon (MD175116) and active in the NPI registry since April 2011. She is enrolled in Medicare PECOS, is affiliated with Sacred Heart Medical Center - Riverbend, and maintains a secondary practice location in Springfield.

NPPES Registry Identity

NPI1366732729
Entity TypeIndividualFemale
Primary Taxonomy208600000X
Provider Legal NameKATELYN ANN CLARKCredential: M.D.
Location AddressPEACEHEALTH SURGICAL SPECIALTIES, 3355 RIVERBEND DR., SUITE 300Springfield, OR 97477
Mailing AddressPeacehealth Surgical Specialties, 3355 Riverbend Dr., Suite 300Springfield, OR 97477 · (541) 222-8333 · Fax (541) 222-8320
Phone(541) 222-8333
Fax(541) 222-8320
Sole ProprietorYes
Medical School CMSOregon Health Sciences University School Of MedicineGraduated 2011
Enumeration DateApril 19, 2011
Last NPPES UpdateFebruary 28, 20247 updates tracked since enumeration
NPPES CertifiedNovember 29, 2022
✔ NPI 1366732729 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in OR · MD175116
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
PEACEHEALTH SURGICAL SPECIALTIES, Springfield, OR 97477
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Secondary Practice Location 1

Location 13377 Riverbend Dr Ste 230Springfield, OR 97477-8806 · Phone (541) 222-2700 · Fax (541) 222-6113

Other Identifiers 1

Medicaid500654943OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Kaiser Permanente, Moda Health Plan, Inc. and more.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

Katelyn Ann Clark 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 ID7911143201
PECOS Enrollment IDI20160727000078
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 7

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.

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
27 services27 patients
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.
22 services20 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
13 services11 patients
Insertion of central venous tube with port (5 years or older) 36561
A central venous tube with port is a small, flexible tube inserted into a large vein, usually in the chest. It allows for easy administration of medication, fluids, or blood products over a long period. A port is attached under the skin for easy access. It's safe for individuals aged 5 and above.
12 services12 patients
Fluoroscopic guidance for insertion or removal of central vein access device 77001
Fluoroscopic guidance for central vein access device insertion or removal is a procedure where a special X-ray, called a fluoroscope, is used to help accurately place or remove a device in a central vein. This device aids in delivering medications or collecting blood samples.
11 services11 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
11 services11 patients

Hospital Affiliations CMS Care Compare

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

Sacred Heart Medical Center - Riverbend

Acute Care Hospitals · Springfield, OR
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number380102
Location3333 Riverbend DriveSpringfield, OR 97477 · Lane County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97477 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
$84.82 typical visit price
range $54.96 – $166.64
Typical copayment $21.20 (range $13.74 – $41.66)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.68 – $136.19
Typical copayment $17.16 (range $4.42 – $34.04)
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.

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.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
34%110 patients2/55-star benchmark: 85%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
99%783 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
85%91 patients2/55-star benchmark: 99%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
87%69 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
22%27 patients2/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
98%123 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
43%152 patients2/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
94%196 patients4/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients tobacco: 75% · 51 patients
82%51 patients
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
61%152 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
10%152 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
2%152 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035
Other-Enteral and Parenteral · category OB006N
2 suppliers15 claims305 services$5.76 avg. paid by Medicare
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152
Other-Enteral and Parenteral · category OB006N
1 supplier11 claims4,453 services$0.28 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 4

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

DANIEL A CUSATI M.D.
Surgery
PEACEHEALTH SURGICAL SPECIALTIES, 3355 RIVERBEND DR., SUITE 300
SPRINGFIELD, OR 97477
Lane County (541) 222-8333
HEIDI MARIE SEMPLE NP
Nurse Practitioner (Family)
PEACEHEALTH SURGICAL SPECIALTIES, 3355 RIVERBEND DR STE 300
SPRINGFIELD, OR 97477
Lane County (541) 222-8333
NICHOLE INGALLS MD
Surgery
PEACEHEALTH SURGICAL SPECIALTIES, 3355 RIVERBEND DR STE 300
SPRINGFIELD, OR 97477
Lane County (541) 222-8333
CAMILLE E. LEIDER NP
Nurse Practitioner (Family)
PEACEHEALTH SURGICAL SPECIALTIES, 3355 RIVERBEND DR STE 300
SPRINGFIELD, OR 97477
Lane County (541) 222-8333

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 Katelyn Clark's NPI number?

The NPI number for Katelyn Clark is 1366732729. It was assigned to this individual provider in the NPPES registry on April 19, 2011.

Where is Katelyn Clark located?

Katelyn Clark practices at Peacehealth Surgical Specialties 3355 Riverbend Dr., Suite 300, Springfield, OR 97477. The listed phone number is (541) 222-8333.

What is Katelyn Clark's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Katelyn Clark enrolled in Medicare?

Yes. Katelyn 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.

What insurance does Katelyn Clark accept?

Health plans from BridgeSpan Health Company, Kaiser Permanente, Moda Health Plan, Inc., PacificSource Health Plans and Providence Health Plan and 1 other insurer list Katelyn Clark 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 Katelyn Clark affiliated with any hospitals?

According to CMS data, Katelyn Clark is affiliated with Sacred Heart Medical Center - Riverbend.

When was this NPI record last updated?

The NPPES record for Katelyn Clark was last updated on February 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.