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DR. CLINTON JAMES MASTERSON M.D.
NPI 1407067168
Emergency Medicine in South Lake Tahoe, CA

Active since May 24, 2007PECOS Enrolled
2170 SOUTH AVE, SOUTH LAKE TAHOE, CA 96150(530) 541-3420 Get Directions Write a Review

NPPES record last updated: October 19, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Clinton James Masterson M.d. NPPES

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

DR. CLINTON JAMES MASTERSON M.D. (NPI 1407067168) is an individual emergency medicine provider in South Lake Tahoe, California, licensed in California (A100433) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS and maintains a secondary practice location in Fairmont.

NPPES Registry Identity

NPI1407067168
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameDR. CLINTON JAMES MASTERSONCredential: M.D.
Location Address2170 SOUTH AVESouth Lake Tahoe, CA 96150-7026
Mailing Address1111 Emerald Bay RdSouth Lake Tahoe, CA 96150-6207 · (530) 543-5652 · Fax (530) 541-8723
Phone(530) 541-3420
Sole ProprietorNo
Enumeration DateMay 24, 2007
Last NPPES UpdateOctober 19, 2020
NPPES CertifiedOctober 19, 2020
✔ NPI 1407067168 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
Licenses✔ Licensed in CA · A100433✔ Licensed in TX · M7408✔ Licensed in NV · 12330✔ Licensed in NY · 234413✔ Licensed in CO · 44775
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
2170 SOUTH AVE, South Lake Tahoe, CA 96150
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Secondary Practice Location 1

Location 1800 Medical Center DrFairmont, MN 56031-4575 · Phone (507) 238-8100

Other Identifiers 2

Medicaid1407067168NV
Medicaid1407067168CA

Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Clinton James Masterson M.d. 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 Reassignments

5

Medicare enrollment records show Clinton Masterson reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Team Physicians Of Nevada-Scherr, P.C.
133 mi
Emergency Medicine
5000 HOPYARD RD, SUITE 100
Pleasanton, CA 94588
  • Reassigned Medicare billing, Nevada enrollment
  • Medicare enrollment name: Team Physicians Of Nevada-Scherr, PC
  • 55 clinicians in this Medicare group
NPI 1073942116 (925) 924-1600
Emergency Professionals Of Colorado, PC
803 mi
Emergency Medicine
2000 BOISE AVE
Loveland, CO 80538
  • Reassigned Medicare billing, Colorado enrollment
  • 111 clinicians in this Medicare group
NPI 1396496469 (970) 820-4640
Mayo Clinic Health System-Fairmont
1,364 mi
Multi-Specialty
800 MEDICAL CENTER DR
Fairmont, MN 56031
  • Reassigned Medicare billing, Minnesota enrollment
  • 806 clinicians in this Medicare group
NPI 1366410862 (507) 238-8100
Emergency Associates Of Central Texas PA
1,364 mi
Emergency Medicine
2201 S CLEAR CREEK RD
Killeen, TX 76549
  • Reassigned Medicare billing, Texas enrollment
  • 214 clinicians in this Medicare group
NPI 1215418280 (865) 693-1000
Mayo Clinic Health System-Southwest Minnesota Region
1,390 mi
Multi-Specialty
1025 MARSH ST
Mankato, MN 56001
  • Reassigned Medicare billing, Minnesota enrollment
  • Also billed through NPI 1124035282 (Minnesota)
  • 1,572 clinicians in this Medicare group
NPI 1578545422 (507) 625-4031

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

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.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
143 services128 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
102 services89 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
29 services26 patients
Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
18 services17 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 96150 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
$92.61 typical visit price
range $60.44 – $180.85
Typical copayment $23.15 (range $15.11 – $45.21)
Most-billed visit code 99203
Established Patient
$105.95 typical visit price
range $19.88 – $148.15
Typical copayment $26.48 (range $4.97 – $37.03)
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.

BARTON HEALTHCARE SYSTEM
General Acute Care Hospital
2170 SOUTH AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 541-3420
MICHELLE APPELLE MSPT
Physical Therapist
2170 SOUTH AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 543-5896
AMY PITTLICK SMITH NP
Nurse Practitioner (Family)
2170 SOUTH AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 539-6620
MICHAEL NEIGER PT
Physical Therapist
2170 SOUTH AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 543-5896
DIANE G OLIVER MD
Pathology (Cytopathology)
2170 SOUTH AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 542-3000
B. PATRICK BAGHDIKIAN
Anesthesiology
2170 SOUTH AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 543-5880
ZACHARY A CHILD MD
Orthopaedic Surgery
2170 SOUTH AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 543-5554
DR. STEFAN ERNEST SCHUNK MD
Internal Medicine
2170 SOUTH AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 541-3420

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 Clinton Masterson's NPI number?

The NPI number for Clinton Masterson is 1407067168. It was assigned to this individual provider in the NPPES registry on May 24, 2007.

Where is Clinton Masterson located?

Clinton Masterson practices at 2170 South Ave, South Lake Tahoe, CA 96150. The listed phone number is (530) 541-3420.

What is Clinton Masterson's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Clinton Masterson enrolled in Medicare?

Yes. Clinton Masterson is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Clinton Masterson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Clinton Masterson reassigns Medicare benefits to 5 organizations: Team Physicians Of Nevada-Scherr, P.C. (Pleasanton, CA), Emergency Professionals Of Colorado, PC (Loveland, CO), Mayo Clinic Health System-Fairmont (Fairmont, MN), Emergency Associates Of Central Texas PA (Killeen, TX) and Mayo Clinic Health System-Southwest Minnesota Region (Mankato, MN). Each 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 Clinton Masterson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Clinton Masterson accept?

Health plans from Blue Cross Blue Shield of Wyoming and Blue Cross and Blue Shield of Texas list Clinton Masterson 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.

When was this NPI record last updated?

The NPPES record for Clinton Masterson was last updated on October 19, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.