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DR. MARY JO KOCARNIK CLARKE MD
NPI 1760586796
Family Medicine in Beaverton, OR

Active since September 11, 2006PECOS Enrolled
4855 SW WESTERN AVE, BEAVERTON, BEAVERTON, OR 97005(503) 643-7565 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Mary Jo Kocarnik Clarke Md NPPES

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

DR. MARY JO KOCARNIK CLARKE MD (NPI 1760586796) is an individual family medicine provider in Beaverton, Oregon, licensed in Oregon (MD15645) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1760586796
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. MARY JO KOCARNIK CLARKECredential: MD
Location Address4855 SW WESTERN AVE, BEAVERTONBeaverton, OR 97005-3460
Mailing Address4855 Sw Western Ave, BeavertonBeaverton, OR 97005-3460
Phone(503) 643-7565
Sole ProprietorNo
Enumeration DateSeptember 11, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1760586796 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 · MD15645
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.
4855 SW WESTERN AVE, Beaverton, OR 97005
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Other Identifiers 1

Medicare UPINEO6510OR

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mary Jo Kocarnik Clarke 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.

Medicare Billing Reassignment

Medicare enrollment records show Mary Jo Clarke reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Beaverton Rehab & Specialty Care, LLC
1.0 mi
Skilled Nursing Facility
11850 SW ALLEN BLVD
Beaverton, OR 97005
  • Reassigned Medicare billing, Oregon enrollment
  • Medicare enrollment name: Kaiser Foundation Health Plan Of The Northwest
  • 3,207 clinicians in this Medicare group
NPI 1366469330 (503) 646-7164

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 97005 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.

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.

MRS. RANDEEP KAUR DA
Dental Assistant
4855 SW WESTERN AVE
BEAVERTON, OR 97005
Washington County (503) 626-4148
CHANNA V HANG PA
Physician Assistant
4855 SW WESTERN AVE
BEAVERTON, OR 97005
Washington County (503) 813-2000
MEDHA CHUNDURU MD
Family Medicine
4855 SW WESTERN AVE
BEAVERTON, OR 97005
Washington County (800) 813-2000
MARYLOU STRONG
Physical Therapist
4855 SW WESTERN AVE
BEAVERTON, OR 97005
Washington County (503) 520-4950
BRADLEY RAY PLANT DPT, CSCS
Physical Therapist
4855 SW WESTERN AVE
BEAVERTON, OR 97005
Washington County (800) 813-2000
AMANDA ANDERSEN
Internal Medicine
4855 SW WESTERN AVE
BEAVERTON, OR 97005
Washington County (503) 813-2000
TINA TRUONG
Dental Hygienist
4855 SW WESTERN AVE
BEAVERTON, OR 97005
Washington County (800) 213-2000
SANDRA MEACHAM REED M.D.
Obstetrics & Gynecology
4855 SW WESTERN AVE
BEAVERTON, OR 97005
Washington County (503) 643-7565

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 Mary Jo Clarke's NPI number?

The NPI number for Mary Jo Clarke is 1760586796. It was assigned to this individual provider in the NPPES registry on September 11, 2006.

Where is Mary Jo Clarke located?

Mary Jo Clarke practices at 4855 SW Western Ave Beaverton, Beaverton, OR 97005. The listed phone number is (503) 643-7565.

What is Mary Jo Clarke's specialty?

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

Is Mary Jo Clarke enrolled in Medicare?

Yes. Mary Jo Clarke is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mary Jo Clarke's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Jo Clarke reassigns Medicare benefits to Beaverton Rehab & Specialty Care, LLC (Beaverton, 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 Mary Jo Clarke's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mary Jo Clarke was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.