Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

SUSAN M CLACK MD
NPI 1669424917
Family Medicine in Tigard, OR

Q: What is Susan Clack's NPI number?

The NPI number for Susan Clack is 1669424917. It was assigned to this individual provider in the NPPES registry on May 16, 2006.

Q: What is Susan Clack's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Susan Clack was last updated on July 23, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 16, 2006PECOS Enrolled

13200 SW PACIFIC HWY, TIGARD, OR 97223(503) 598-2000(503) 639-0920 Get Directions Write a Review

NPPES record last updated: July 23, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Susan M Clack Md NPPES

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

SUSAN M CLACK MD (NPI 1669424917) is an individual family medicine provider in Tigard, Oregon, licensed in Oregon (MD14435) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669424917

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameSUSAN M CLACKCredential: MD

Location Address13200 SW PACIFIC HWYTigard, OR 97223-4828

Mailing AddressPo Box 1517Pendleton, OR 97801-0410 · (877) 708-1119 · Fax (541) 278-8349

Phone(503) 598-2000

Fax(503) 639-0920

Sole ProprietorNo

Enumeration DateMay 16, 2006

Last NPPES UpdateJuly 23, 2026

NPPES CertifiedJuly 23, 2026

✔ NPI 1669424917 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in OR · MD14435

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

13200 SW PACIFIC HWY, Tigard, OR 97223

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Other Identifiers 2

Medicaid142307OR

Other08118136Rr Pin

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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Susan M Clack Md 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 97223 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

$90.51 typical visit price

range $58.99 – $176.88

Typical copayment $22.62 (range $14.74 – $44.22)

Most-billed visit code 99203

Established Patient

$103.51 typical visit price

range $19.32 – $144.79

Typical copayment $25.87 (range $4.83 – $36.19)

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.

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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.

JOSE S DE LA CRUZ MD

Family Medicine