KYLE R CLARK PA-C
NPI 1801415864
Physician Assistant in Rockford, IL

Q: What is Kyle Clark's NPI number?

The NPI number for Kyle Clark is 1801415864. It was assigned to this individual provider in the NPPES registry on April 10, 2020.

Q: What is Kyle Clark's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Kyle Clark was last updated on April 10, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since April 10, 2020PECOS EnrolledAccepts Medicare Assignment

5666 E STATE ST, ROCKFORD, IL 61108(815) 226-2000 Get Directions Write a Review

NPPES record last updated: April 10, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Kyle R Clark Pa-c NPPES

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

KYLE R CLARK PA-C (NPI 1801415864) is an individual physician assistant in Rockford, Illinois, licensed in Illinois (085.007488) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS, is affiliated with St Mary Medical Center, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1801415864

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameKYLE R CLARKCredential: PA-C

Location Address5666 E STATE STRockford, IL 61108-2425

Mailing Address1395 Jay StFreeport, IL 61032-8424 · (815) 291-4052

Phone(815) 226-2000

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateApril 10, 2020

NPPES CertifiedApril 10, 2020

✔ NPI 1801415864 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 IL · 085.007488

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.

5666 E STATE ST, Rockford, IL 61108

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.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

Kyle R Clark Pa-c 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 ID648692038

PECOS Enrollment IDI20200611001994

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 9

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.

494 services403 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

420 services349 patients

Ultrasound measurement of bladder capacity after voiding 51798

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

398 services322 patients

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.

125 services74 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

69 services69 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.

55 services52 patients

Hospital Affiliations CMS Care Compare 3

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

St Mary Medical Center

Acute Care Hospitals · Galesburg, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140064

Location3333 North SeminaryGalesburg, IL 61401 · Knox County

Emergency services Birthing friendly

Saint Francis Medical Center

Acute Care Hospitals · Peoria, IL

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140067

Location530 NE Glen Oak AvePeoria, IL 61637 · Peoria County

Emergency services Birthing friendly

Osf Saint Luke Medical Center

Critical Access Hospitals · Kewanee, IL

OwnershipVoluntary non-profit - Private

CMS Certification Number141325

Location1051 West South StreetKewanee, IL 61443 · Henry County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61108 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

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$68.64 typical visit price

range $17.16 – $136.56

Typical copayment $17.16 (range $4.29 – $34.14)

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.

Referred Medical Equipment & Supplies CMS DME claims

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

Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each A4352

DME-Orthotic Devices · category DF008N

1 supplier26 claims4,560 services$5.24 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.

REGIONAL CARDIOLOGY CONSULTANTS LTD

Specialist