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MRS. SHANTA LYNN CLARK P.A.-C
NPI 1790169688
Physician Assistant in Dowagiac, MI

Active since July 10, 2015PECOS Enrolled
84.62/100
CMS Quality Rating
58620 SINK RD, POKAGON HEALTH SERVICES, DOWAGIAC, MI 49047(269) 782-4141 Get Directions Write a Review

NPPES record last updated: July 10, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Shanta Lynn Clark P.a.-c NPPES

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

MRS. SHANTA LYNN CLARK P.A.-C (NPI 1790169688) is an individual physician assistant in Dowagiac, Michigan, licensed in Michigan (5601007413) and active in the NPI registry since July 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790169688
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMRS. SHANTA LYNN CLARKCredential: P.A.-C
Location Address58620 SINK RD, POKAGON HEALTH SERVICESDowagiac, MI 49047-9329
Mailing Address58620 Sink Rd, Pokagon Health ServicesDowagiac, MI 49047-9329 · (269) 782-4141
Phone(269) 782-4141
Sole ProprietorNo
Enumeration DateJuly 10, 2015
✔ NPI 1790169688 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in MI · 5601007413
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.
58620 SINK RD, Dowagiac, MI 49047
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community 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)

Mrs. Shanta Lynn Clark P.a.-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 49047 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
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
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.

84.62/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality98.09
Promoting Interoperability100
Improvement Activities40
Cost50.64

Other Providers at the Same Location NPPES 5

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

IRIS ANNE GRONAU
Dietitian, Registered
58620 SINK RD
DOWAGIAC, MI 49047
Cass County (269) 782-4141
ALEXANDER ROWLAND
Counselor (Mental Health)
58620 SINK RD
DOWAGIAC, MI 49047
Cass County (269) 782-4885
KRISTINE MICHELE ZELMER RDH
Dental Hygienist
58620 SINK RD
DOWAGIAC, MI 49047
Cass County (269) 783-2495
DELPHINE COLAR DO
Family Medicine
58620 SINK RD
DOWAGIAC, MI 49047
Cass County (269) 782-4141
JOO-YOUN YI D.D.S.
Dentist (General Practice)
58620 SINK RD
DOWAGIAC, MI 49047
Cass County (269) 783-2495

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 Shanta Clark's NPI number?

The NPI number for Shanta Clark is 1790169688. It was assigned to this individual provider in the NPPES registry on July 10, 2015.

Where is Shanta Clark located?

Shanta Clark practices at 58620 Sink Rd Pokagon Health Services, Dowagiac, MI 49047. The listed phone number is (269) 782-4141.

What is Shanta Clark's specialty?

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

Is Shanta Clark enrolled in Medicare?

Yes. Shanta Clark is registered in the Medicare PECOS enrollment system.

What insurance does Shanta Clark accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and Priority Health list Shanta 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.

When was this NPI record last updated?

The NPPES record for Shanta Clark was last updated on July 10, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.