MACEY CLARK PNP-C, AGNP-C
NPI 1417483553
Nurse Practitioner - Family in La Grande, OR

Q: What is Macey Clark's NPI number?

The NPI number for Macey Clark is 1417483553. It was assigned to this individual provider in the NPPES registry on May 10, 2017.

Q: What is Macey Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Macey Clark was last updated on May 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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 May 10, 2017PECOS Enrolled

710 SUNSET DR, SUITE E, LA GRANDE, OR 97850(541) 962-5600 Get Directions Write a Review

NPPES record last updated: May 29, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 29, 2025, May 10, 2017 (2 updates tracked since 2017).

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About Macey Clark Pnp-c, Agnp-c NPPES

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

MACEY CLARK PNP-C, AGNP-C (NPI 1417483553) is an individual family provider in La Grande, Oregon, licensed in Oregon (201704371NP-PP) and active in the NPI registry since May 2017. She is enrolled in Medicare PECOS and maintains a secondary practice location in Union.

NPPES Registry Identity

NPI1417483553

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMACEY CLARKCredential: PNP-C, AGNP-C

Location Address710 SUNSET DR, SUITE ELa Grande, OR 97850-1200

Mailing AddressPo Box 3290La Grande, OR 97850-7290 · (541) 963-1967 · Fax (541) 963-1837

Phone(541) 962-5600

Sole ProprietorNo

Enumeration DateMay 10, 2017

Last NPPES UpdateMay 29, 20252 updates tracked since enumeration

NPPES CertifiedMay 29, 2025

✔ NPI 1417483553 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in OR · 201704371NP-PP

Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X · License 201704371NP-PP (OR)

710 SUNSET DR, La Grande, OR 97850

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Secondary Practice Location 1

Location 1142 E Dearborn StUnion, OR 97883-9174 · Phone (541) 562-6180 · Fax (541) 562-6186

Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Macey Clark Pnp-c, Agnp-c 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 Reassignment

Medicare enrollment records show Macey Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grande Ronde Hospital, Inc.

0.1 mi

Critical Access

900 SUNSET DR
La Grande, OR 97850

Reassigned Medicare billing, Oregon enrollment
158 clinicians in this Medicare group

NPI 1467446195 (541) 963-1472

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97850 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

$97.16 typical visit price

range $17.68 – $136.19

Typical copayment $24.29 (range $4.42 – $34.04)

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 8

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

MICHAEL JOSEPH STURMAK CCC-A

Audiologist-Hearing Aid Fitter

710 SUNSET DR
LA GRANDE, OR 97850

Union County (541) 963-8643

JOHN SCHAEFER MD PC

Family Medicine

710 SUNSET DR, SUITE C
LA GRANDE, OR 97850

Union County (541) 963-4139

JOSEPH L. PETRUSEK, M.D., P.C.

Otolaryngology

710 SUNSET DR, STE. D
LA GRANDE, OR 97850

Union County (541) 963-8643

KIM R. MONTEE, M.D., P.C.

Family Medicine

710 SUNSET DR, SUITE C
LA GRANDE, OR 97850

Union County (541) 963-4139

DR. JOSEPH LOUIS PETRUSEK M.D., P.C.

Otolaryngology

710 SUNSET DR, STE. D
LA GRANDE, OR 97850

Union County (541) 963-8643

DONALD O. WARREN M.D.

Orthopaedic Surgery

710 SUNSET DR
LA GRANDE, OR 97850

Union County (541) 663-3100

NICHOLAS GABRIEL VECE QMHA-I

Case Manager/Care Coordinator

710 SUNSET DR
LA GRANDE, OR 97850

Union County (541) 663-3150

DR. LESLIE W JACKSON MD

Internal Medicine (Rheumatology)

710 SUNSET DR
LA GRANDE, OR 97850

Union County (541) 663-3000

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 Macey Clark's NPI number?

The NPI number for Macey Clark is 1417483553. It was assigned to this individual provider in the NPPES registry on May 10, 2017.

Where is Macey Clark located?

Macey Clark practices at 710 Sunset Dr Suite E, La Grande, OR 97850. The listed phone number is (541) 962-5600.

What is Macey Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Macey Clark enrolled in Medicare?

Yes. Macey Clark is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Macey Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Macey Clark reassigns Medicare benefits to Grande Ronde Hospital, Inc. (La Grande, OR). The 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 Macey Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Macey Clark accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and Regence BlueCross BlueShield of Oregon list Macey 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.

When was this NPI record last updated?

The NPPES record for Macey Clark was last updated on May 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.