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STACEY CLARK PA
NPI 1710968763
Physician Assistant in Penacook, NH

Active since November 08, 2005PECOS EnrolledAccepts Medicare Assignment
89.36/100
CMS Quality Rating
4 CRESCENT ST., PENACOOK, NH 03303(603) 753-4302(603) 227-7570 Get Directions Write a Review

NPPES record last updated: September 30, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Stacey Clark Pa NPPES

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

STACEY CLARK PA (NPI 1710968763) is an individual physician assistant in Penacook, New Hampshire, licensed in New Hampshire (0622) and active in the NPI registry since November 2005. She is enrolled in Medicare PECOS, is affiliated with Concord Hospital, and maintains a secondary practice location in Manchester.

NPPES Registry Identity

NPI1710968763
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameSTACEY CLARKCredential: PA
Location Address4 CRESCENT ST.Penacook, NH 03303-1412
Mailing Address4 Crescent StPenacook, NH 03303-1412 · (603) 753-4302
Phone(603) 753-4302
Fax(603) 227-7570
Sole ProprietorNo
Medical School CMSOtherGraduated 1998
Enumeration DateNovember 8, 2005
Last NPPES UpdateSeptember 30, 2022
NPPES CertifiedSeptember 30, 2022
✔ NPI 1710968763 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 NH · 0622
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 ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License 2511 (AZ)
4 CRESCENT ST., Penacook, NH 03303
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Other Names 1

Former Name (1)Stacey Ort Pa

Secondary Practice Location 1

Location 11 Elliot Way, Merrimack Emergency PhysiciansManchester, NH 03103 · Phone (603) 663-2830 · Fax (603) 663-1849

Other Identifiers 1

Medicaid3073660NH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Arizona 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 and accepts Medicare assignment

Stacey Clark Pa 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 ID3274581061
PECOS Enrollment IDI20070829000610
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 5

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.

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.
210 services116 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
72 services72 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
61 services51 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.
22 services19 patients
Transitional care management services for problem of at least moderate complexity 99495
Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.
12 services11 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Concord Hospital

Acute Care Hospitals · Concord, NH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number300001
Location250 Pleasant StConcord, NH 03301 · Merrimack County
Birthing friendly

Concord Hospital- Laconia

Acute Care Hospitals · Laconia, NH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number300005
Location80 Highland StLaconia, NH 03246 · Belknap County
Emergency services

Concord Hospital- Franklin

Critical Access Hospitals · Franklin, NH
OwnershipVoluntary non-profit - Private
CMS Certification Number301306
Location15 Aiken AvenueFranklin, NH 03235 · Merrimack County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 03303 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
$89.14 typical visit price
range $57.75 – $174.26
Typical copayment $22.28 (range $14.43 – $43.56)
Most-billed visit code 99203
Established Patient
$71.85 typical visit price
range $18.70 – $142.15
Typical copayment $17.96 (range $4.67 – $35.53)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

89.36/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality72.19
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 3

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

INSHA HAQUE D.O.
Family Medicine
4 CRESCENT ST.
PENACOOK, NH 03303
Merrimack County (603) 753-4302
GALINA PAVLENCHEVA DO
Family Medicine
4 CRESCENT ST.
PENACOOK, NH 03303
Merrimack County (603) 753-4302
MARGARITA SHUGOL DO
Family Medicine
4 CRESCENT ST.
PENACOOK, NH 03303
Merrimack County (603) 753-4302

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 Stacey Clark's NPI number?

The NPI number for Stacey Clark is 1710968763. It was assigned to this individual provider in the NPPES registry on November 8, 2005. The provider is also known as Stacey Ort PA.

Where is Stacey Clark located?

Stacey Clark practices at 4 Crescent St., Penacook, NH 03303. The listed phone number is (603) 753-4302.

What is Stacey Clark's specialty?

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

Is Stacey Clark enrolled in Medicare?

Yes. Stacey Clark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Stacey Clark accept?

Health plans from Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Arizona and Harvard Pilgrim Health Care list Stacey 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.

Is Stacey Clark affiliated with any hospitals?

According to CMS data, Stacey Clark is affiliated with Concord Hospital, Concord Hospital- Laconia and Concord Hospital- Franklin.

When was this NPI record last updated?

The NPPES record for Stacey Clark was last updated on September 30, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.