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DR. NICOLE ANNE CLARK MD
NPI 1760598411
Family Medicine in Provo, UT

Active since August 22, 2006PECOS EnrolledAccepts Medicare Assignment

NPPES record last updated: January 21, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Dr. Nicole Anne Clark Md NPPES

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

DR. NICOLE ANNE CLARK MD (NPI 1760598411) is an individual family medicine provider in Provo, Utah, licensed in Utah (4775416-1205) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS, is affiliated with Utah Valley Hospital, and is a graduate of University Of Vermont College Of Medicine (1999).

NPPES Registry Identity

NPI1760598411
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. NICOLE ANNE CLARKCredential: MD
Location Address475 W 940 NProvo, UT 84604-3301
Mailing AddressPo Box 27128Salt Lake City, UT 84127-0128 · (801) 357-7930
Phone(801) 357-7930
Sole ProprietorNo
Medical School CMSUniversity Of Vermont College Of MedicineGraduated 1999
Enumeration DateAugust 22, 2006
Last NPPES UpdateJanuary 21, 2026
NPPES CertifiedJanuary 21, 2026
✔ NPI 1760598411 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in UT · 4775416-1205
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.
475 W 940 N, Provo, UT 84604
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Select Health.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

Dr. Nicole Anne Clark Md 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 ID2163452657
PECOS Enrollment IDI20050815000642
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 6

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
118 services59 patients
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.
91 services56 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
51 services47 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.
50 services50 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.
49 services44 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
48 services48 patients

Hospital Affiliations CMS Care Compare 4

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

Utah Valley Hospital

Acute Care Hospitals · Provo, UT
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number460001
Location1034 North 500 WestProvo, UT 84604 · Utah County
Emergency services Birthing friendly

American Fork Hospital

Acute Care Hospitals · American Fork, UT
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number460023
Location170 North 1100 EastAmerican Fork, UT 84003 · Utah County
Emergency services Birthing friendly

Orem Community Hospital

Acute Care Hospitals · Orem, UT
OwnershipVoluntary non-profit - Private
CMS Certification Number460043
Location331 North 400 WestOrem, UT 84057 · Utah County
Emergency services Birthing friendly

Spanish Fork Hospital

Acute Care Hospitals · Spanish Fork, UT
OwnershipVoluntary non-profit - Private
CMS Certification Number460062
Location765 East Market Place DriveSpanish Fork, UT 84660 · Utah County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84604 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Standard wheelchair K0001
DME-Wheelchairs · category DD000N
1 supplier14 claims14 services$17.33 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
1 supplier11 claims11 services$213.21 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

MR. TYLER JASON FIELDSTED DO
Family Medicine
475 W 940 N
PROVO, UT 84604
Utah County (801) 357-7926
KARLY GARDNER DO
Family Medicine
475 W 940 N
PROVO, UT 84604
Utah County (801) 357-7930
TYSON DEKORSE M.D.
Student in an Organized Health Care Education/Training Program
475 W 940 N
PROVO, UT 84604
Utah County (801) 357-7940
SAMANTHA BENGTZEN DERZON MD
Family Medicine
475 W 940 N
PROVO, UT 84604
Utah County (801) 357-7940
EASTON E WEAVER
Student in an Organized Health Care Education/Training Program
475 W 940 N
PROVO, UT 84604
Utah County (801) 357-7930
MARK CONLEY DO
Student in an Organized Health Care Education/Training Program
475 W 940 N
PROVO, UT 84604
Utah County (801) 357-7930
DR. JASON ROBERT HERMAN D.O.
Family Medicine
475 W 940 N
PROVO, UT 84604
Utah County (801) 357-7930
MARIANGELA SANTIAGO PARRA DO
Student in an Organized Health Care Education/Training Program
475 W 940 N
PROVO, UT 84604
Utah County (801) 357-7930

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 Nicole Clark's NPI number?

The NPI number for Nicole Clark is 1760598411. It was assigned to this individual provider in the NPPES registry on August 22, 2006.

Where is Nicole Clark located?

Nicole Clark practices at 475 W 940 N, Provo, UT 84604. The listed phone number is (801) 357-7930.

What is Nicole Clark's specialty?

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

Is Nicole Clark enrolled in Medicare?

Yes. Nicole 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 Nicole Clark accept?

Health plans from Select Health list Nicole 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 Nicole Clark affiliated with any hospitals?

According to CMS data, Nicole Clark is affiliated with Utah Valley Hospital, American Fork Hospital, Orem Community Hospital and Spanish Fork Hospital.

When was this NPI record last updated?

The NPPES record for Nicole Clark was last updated on January 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.