MR. CLARK MORRIS HATHEWAY
NPI 1861955783
Internal Medicine in Kirkland, WA

Q: What is Clark Hatheway's NPI number?

The NPI number for Clark Hatheway is 1861955783. It was assigned to this individual provider in the NPPES registry on April 8, 2019.

Q: What is Clark Hatheway's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Clark Hatheway was last updated on August 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 08, 2019PECOS EnrolledAccepts Medicare Assignment

12910 TOTEM LAKE BLVD NE STE 101, KIRKLAND, WA 98034(425) 814-5000 Get Directions Write a Review

NPPES record last updated: August 5, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 5, 2022, Apr 8, 2019 (2 updates tracked since 2019).

On this page

About Mr. Clark Morris Hatheway NPPES

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

MR. CLARK MORRIS HATHEWAY (NPI 1861955783) is an individual internal medicine provider in Kirkland, Washington, licensed in Washington (MD61263733) and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS, is affiliated with Evergreenhealth Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1861955783

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameMR. CLARK MORRIS HATHEWAY

Location Address12910 TOTEM LAKE BLVD NE STE 101Kirkland, WA 98034-2901

Mailing Address12910 Totem Lake Blvd Ne Ste 101Kirkland, WA 98034-2901 · (425) 814-5000

Phone(425) 814-5000

Sole ProprietorNo

Medical School CMSUniversity Of Pittsburgh School Of MedicineGraduated 2019

Enumeration DateApril 8, 2019

Last NPPES UpdateAugust 5, 20222 updates tracked since enumeration

NPPES CertifiedAugust 5, 2022

✔ NPI 1861955783 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in WA · MD61263733

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

12910 TOTEM LAKE BLVD NE STE 101, Kirkland, WA 98034

Open in Google Maps ↗

Secondary Practice Locations 2

Location 12351 Clay St Ste 380San Francisco, CA 94115-1931 · Phone (415) 600-6000

Location 21101 Van Ness Ave Ste 1120San Francisco, CA 94109-6919 · Phone (415) 600-6000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.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

Mr. Clark Morris Hatheway 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 ID3375928179

PECOS Enrollment IDI20220914003397

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 7

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.

115 services86 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.

52 services50 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.

45 services45 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

29 services25 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

18 services18 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

16 services16 patients

Hospital Affiliations CMS Care Compare 2

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

Evergreenhealth Medical Center

Acute Care Hospitals · Kirkland, WA

5/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number500124

Location12040 NE 128th StreetKirkland, WA 98034 · King County

Emergency services Birthing friendly

Swedish Issaquah

Acute Care Hospitals · Issaquah, WA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number500152

Location751 NE Blakely DrIssaquah, WA 98029 · King County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98034 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

$143.76 typical visit price

range $63.67 – $189.37

Typical copayment $35.94 (range $15.91 – $47.34)

Most-billed visit code 99204

Established Patient

$111.00 typical visit price

range $21.12 – $155.00

Typical copayment $27.75 (range $5.28 – $38.75)

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 5

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

MICHAEL SU MD

Internal Medicine