CLARK B WYSONG MD
NPI 1861469165
Family Medicine in Glendale, AZ

Q: What is Clark Wysong's NPI number?

The NPI number for Clark Wysong is 1861469165. It was assigned to this individual provider in the NPPES registry on March 6, 2006.

Q: What is Clark Wysong's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Clark Wysong was last updated on January 10, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 06, 2006PECOS EnrolledAccepts Medicare Assignment

19875 N 51ST AVE, GLENDALE, AZ 85308(623) 581-8998(623) 581-6461 Get Directions Write a Review

NPPES record last updated: January 10, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Clark B Wysong Md NPPES

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

CLARK B WYSONG MD (NPI 1861469165) is an individual family medicine provider in Glendale, Arizona, licensed in Arizona (25168) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Oklahoma College Of Medicine (1994).

NPPES Registry Identity

NPI1861469165

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameCLARK B WYSONGCredential: MD

Location Address19875 N 51ST AVEGlendale, AZ 85308-5114

Mailing Address19875 N 51st AveGlendale, AZ 85308-5114 · (623) 581-8998 · Fax (623) 581-6461

Phone(623) 581-8998

Fax(623) 581-6461

Sole ProprietorNo

Medical School CMSUniversity Of Oklahoma College Of MedicineGraduated 1994

Enumeration DateMarch 6, 2006

Last NPPES UpdateJanuary 10, 2013

✔ NPI 1861469165 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in AZ · 25168

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.

19875 N 51ST AVE, Glendale, AZ 85308

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Other Identifiers 3

Medicare PINZ104755AZ

Medicare UPING27560AZ

Medicaid385527AZ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona.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

Clark B Wysong 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 ID6507756319

PECOS Enrollment IDI20040316001418

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.

225 services164 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.

127 services127 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.

109 services90 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

23 services16 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

18 services18 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

18 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85308 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

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

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

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

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

3 suppliers19 claims19 services$20.78 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 16

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

HEATHER GEYMAN FNP

Nurse Practitioner (Family)