SHANE B CLARK DO
NPI 1902391477
Internal Medicine - Hematology & Oncology in Fleming Island, FL

Q: What is Shane Clark's NPI number?

The NPI number for Shane Clark is 1902391477. It was assigned to this individual provider in the NPPES registry on June 27, 2018.

Q: What is Shane Clark's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Q: When was this NPI record last updated?

The NPPES record for Shane Clark was last updated on April 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.

Active since June 27, 2018PECOS EnrolledAccepts Medicare Assignment

2310 VILLAGE SQUARE PKWY STE 106C, FLEMING ISLAND, FL 32003(904) 202-7300(904) 202-2754 Get Directions Write a Review

NPPES record last updated: April 30, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Shane B Clark Do NPPES

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

SHANE B CLARK DO (NPI 1902391477) is an individual hematology & oncology provider in Fleming Island, Florida, licensed in Florida (OS21375) and active in the NPI registry since June 2018. He is enrolled in Medicare PECOS, is affiliated with Baptist Health Medical Center - Jacksonville, and maintains a secondary practice location in Jacksonville.

NPPES Registry Identity

NPI1902391477

Entity TypeIndividualMale

Primary Taxonomy207RH0003X

Provider Legal NameSHANE B CLARKCredential: DO

Location Address2310 VILLAGE SQUARE PKWY STE 106CFleming Island, FL 32003-6409

Mailing AddressPo Box 746654Atlanta, GA 30374-6654 · (904) 202-2092 · Fax (904) 376-4075

Phone(904) 202-7300

Fax(904) 202-2754

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateJune 27, 2018

Last NPPES UpdateApril 30, 2025

NPPES CertifiedApril 30, 2025

✔ NPI 1902391477 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians

Taxonomy Code207RH0003X

License✔ Licensed in FL · OS21375

Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

Also ListedInternal Medicine · HematologyTaxonomy 207RH0000X · License OS21375 (FL)

Also ListedInternal Medicine · Medical OncologyTaxonomy 207RX0202X · License OS21375 (FL)

2310 VILLAGE SQUARE PKWY STE 106C, Fleming Island, FL 32003

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Secondary Practice Location 1

Location 11301 Palm Ave Ste 700Jacksonville, FL 32207-8457 · Phone (904) 202-7300 · Fax (904) 202-2754

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).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

Shane B Clark Do 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 ID1153679394

PECOS Enrollment IDI20240903001293

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 4

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.

94 services76 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.

32 services29 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.

26 services26 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.

24 services24 patients

Hospital Affiliations CMS Care Compare

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

Baptist Health Medical Center - Jacksonville

Acute Care Hospitals · Jacksonville, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100088

Location800 Prudential DrJacksonville, FL 32207 · Duval County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32003 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

$171.84 typical visit price

range $56.00 – $171.84

Typical copayment $42.96 (range $14.00 – $42.96)

Most-billed visit code 99205

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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 3

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

TIFFANY MERCEDES CONNORS APRN

Nurse Practitioner

2310 VILLAGE SQUARE PKWY STE 106C
FLEMING ISLAND, FL 32003

Duval County (904) 202-7300

BAPTIST MD ANDERSON CANCER PHYSICIANS

Radiology (Radiation Oncology)

2310 VILLAGE SQUARE PKWY STE 106C
FLEMING ISLAND, FL 32003

Duval County (904) 202-7300

NEENAD MAHENDRA SHAH MD

Radiology (Radiation Oncology)

2310 VILLAGE SQUARE PKWY STE 106C
FLEMING ISLAND, FL 32003

Duval County (904) 202-7300

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 Shane Clark's NPI number?

The NPI number for Shane Clark is 1902391477. It was assigned to this individual provider in the NPPES registry on June 27, 2018.

Where is Shane Clark located?

Shane Clark practices at 2310 Village Square Pkwy Ste 106C, Fleming Island, FL 32003. The listed phone number is (904) 202-7300.

What is Shane Clark's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Is Shane Clark enrolled in Medicare?

Yes. Shane 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 Shane Clark accept?

Health plans from AvMed, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Shane 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 Shane Clark affiliated with any hospitals?

According to CMS data, Shane Clark is affiliated with Baptist Health Medical Center - Jacksonville.

When was this NPI record last updated?

The NPPES record for Shane Clark was last updated on April 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.