MR. LUKE SAMUEL CLARK PA-C
NPI 1417425240
Physician Assistant in Charlotte, NC

Q: What is Luke Clark's NPI number?

The NPI number for Luke Clark is 1417425240. It was assigned to this individual provider in the NPPES registry on November 9, 2018.

Q: What is Luke Clark's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Luke Clark was last updated on October 26, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since November 09, 2018PECOS EnrolledAccepts Medicare Assignment

200 HAWTHORNE LN, CHARLOTTE, NC 28204(704) 384-5600 Get Directions Write a Review

NPPES record last updated: October 26, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 26, 2020, Feb 15, 2019, Nov 23, 2018 and 1 more (4 updates tracked since 2018).

On this page

About Mr. Luke Samuel Clark Pa-c NPPES

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

MR. LUKE SAMUEL CLARK PA-C (NPI 1417425240) is an individual physician assistant in Charlotte, North Carolina, licensed in North Carolina (0010-08529) and active in the NPI registry since November 2018. He is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1417425240

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameMR. LUKE SAMUEL CLARKCredential: PA-C

Location Address200 HAWTHORNE LNCharlotte, NC 28204-2515

Mailing AddressPo Box 60447Charlotte, NC 28260-0447 · (704) 384-1246 · Fax (704) 384-1249

Phone(704) 384-5600

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateNovember 9, 2018

Last NPPES UpdateOctober 26, 20204 updates tracked since enumeration

NPPES CertifiedSeptember 6, 2020

✔ NPI 1417425240 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in NC · 0010-08529

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

200 HAWTHORNE LN, Charlotte, NC 28204

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.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

Mr. Luke Samuel Clark Pa-c 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 ID446595185

PECOS Enrollment IDI20181227000691

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 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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

84 services35 patients

Psychiatric diagnostic evaluation with medical services 90792

A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.

65 services64 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.

32 services14 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.

17 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28204 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

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

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.

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.

WELO SYLVIE OLENGA CRNA

Nurse Anesthetist, Certified Registered