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JIMMY CLARK JR. P.A. - C
NPI 1891164372
Physician Assistant in Madison, WI

Active since September 15, 2015PECOS EnrolledAccepts Medicare Assignment
95.03/100
CMS Quality Rating
5512 SPRING TIDE WAY, MADISON, WI 53718(224) 848-0612 Get Directions Write a Review

NPPES record last updated: June 9, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Jimmy Clark Jr. P.a. - C NPPES

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

JIMMY CLARK JR. P.A. - C (NPI 1891164372) is an individual physician assistant in Madison, Wisconsin, licensed in Wisconsin (3614) and active in the NPI registry since September 2015. He is enrolled in Medicare PECOS, is affiliated with University Of Wi Hospitals & Clinics Authority, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1891164372
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJIMMY CLARK JR.Credential: P.A. - C
Location Address5512 SPRING TIDE WAYMadison, WI 53718-9125
Mailing Address5512 Spring Tide WayMadison, WI 53718-9125
Phone(224) 848-0612
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateSeptember 15, 2015
Last NPPES UpdateJune 9, 2026
NPPES CertifiedJune 9, 2026
✔ NPI 1891164372 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 WI · 3614
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.
5512 SPRING TIDE WAY, Madison, WI 53718
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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

Jimmy Clark Jr. P.a. - 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 ID4789993049
PECOS Enrollment IDI20151028000000
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 3

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.

Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
29 services29 patients
Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
26 services26 patients
Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
12 services12 patients

Hospital Affiliations CMS Care Compare 2

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

University Of Wi Hospitals & Clinics Authority

Acute Care Hospitals · Madison, WI
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number520098
Location600 Highland AvenueMadison, WI 53792 · Dane County
Emergency services

Stoughton Hospital

Critical Access Hospitals · Stoughton, WI
OwnershipVoluntary non-profit - Private
CMS Certification Number521343
Location900 Ridge StStoughton, WI 53589 · Dane County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53718 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
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.

95.03/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality96.47
Improvement Activities40
Cost82.55

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 Jimmy Clark's NPI number?

The NPI number for Jimmy Clark is 1891164372. It was assigned to this individual provider in the NPPES registry on September 15, 2015.

Where is Jimmy Clark located?

Jimmy Clark practices at 5512 Spring Tide Way, Madison, WI 53718. The listed phone number is (224) 848-0612.

What is Jimmy Clark's specialty?

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

Is Jimmy Clark enrolled in Medicare?

Yes. Jimmy 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 Jimmy Clark accept?

Health plans from Anthem Blue Cross and Blue Shield list Jimmy 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 Jimmy Clark affiliated with any hospitals?

According to CMS data, Jimmy Clark is affiliated with University Of Wi Hospitals & Clinics Authority and Stoughton Hospital.

When was this NPI record last updated?

The NPPES record for Jimmy Clark was last updated on June 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.