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CHARLES JOSEPH CLANCY PA-C
NPI 1669410924
Physician Assistant in Fort Walton Beach, FL

Active since June 02, 2006PECOS Enrolled
1005 MAR WALT DR, IMMEDIATE CARE DEPARTMENT, FORT WALTON BEACH, FL 32547(850) 863-8219(850) 863-8249 Get Directions Write a Review

NPPES record last updated: November 15, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Charles Joseph Clancy Pa-c NPPES

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

CHARLES JOSEPH CLANCY PA-C (NPI 1669410924) is an individual physician assistant in Fort Walton Beach, Florida, licensed in Florida (PA9103700) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669410924
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameCHARLES JOSEPH CLANCYCredential: PA-C
Location Address1005 MAR WALT DR, IMMEDIATE CARE DEPARTMENTFort Walton Beach, FL 32547-6707
Mailing Address1005 Mar Walt Drive, Immediate Care DepartmentFort Walton Beach, FL 32547-6796 · (850) 863-8219 · Fax (850) 863-8249
Phone(850) 863-8219
Fax(850) 863-8249
Sole ProprietorNo
Enumeration DateJune 2, 2006
Last NPPES UpdateNovember 15, 2010
✔ NPI 1669410924 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in FL · PA9103700
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.
Also ListedEmergency MedicineTaxonomy 207P00000X · License PA9103700 (FL)
1005 MAR WALT DR, Fort Walton Beach, FL 32547
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Other Identifiers 2

Medicare PINU7503UFL
Medicaid292457900FL

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Charles Joseph Clancy Pa-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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32547 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
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.

PETER H SHIH M.D.
Internal Medicine (Critical Care Medicine)
1005 MAR WALT DR
FORT WALTON BEACH, FL 32547
Okaloosa County (850) 243-0118
DR. TERRY L PAYNE M.D.
Family Medicine
1005 MAR WALT DR
FORT WALTON BEACH, FL 32547
Okaloosa County (850) 863-6600
LESLIE MARIE ANDERSON LDN RD
Dietitian, Registered
1005 MAR WALT DR
FORT WALTON BEACH, FL 32547
Okaloosa County (850) 863-6600
DR. KARL WALTER METZ M.D.
Obstetrics & Gynecology (Gynecology)
1005 MAR WALT DR, LABORATORY
FORT WALTON BEACH, FL 32547
Okaloosa County (850) 863-8109
WHITE-WILSON MEDICAL CENTER, P.A.
Family Medicine
1005 MAR WALT DR, FP DEPARTMENT
FORT WALTON BEACH, FL 32547
Okaloosa County (850) 863-6600
BRIANNE FREEL
Nurse Practitioner (Family)
1005 MAR WALT DR
FORT WALTON BEACH, FL 32547
Okaloosa County (850) 863-6600
MICHAEL ANDREW JOHNSON PA-C
Physician Assistant
1005 MAR WALT DR, INTERNAL MEDICINE DEPARTMENT
FORT WALTON BEACH, FL 32547
Okaloosa County (850) 863-8202
MR. FABIAN RODRIGUEZ NP
Nurse Practitioner (Family)
1005 MAR WALT DR
FORT WALTON BEACH, FL 32547
Okaloosa County (850) 863-8100

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 Charles Clancy's NPI number?

The NPI number for Charles Clancy is 1669410924. It was assigned to this individual provider in the NPPES registry on June 2, 2006.

Where is Charles Clancy located?

Charles Clancy practices at 1005 Mar Walt Dr Immediate Care Department, Fort Walton Beach, FL 32547. The listed phone number is (850) 863-8219.

What is Charles Clancy's specialty?

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

Is Charles Clancy enrolled in Medicare?

Yes. Charles Clancy is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Charles Clancy was last updated on November 15, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.