TIMOTHY MICHAEL CLARK CRNA
NPI 1912017039
Nurse Anesthetist, Certified Registered in Tyler, TX
About Timothy Michael Clark Crna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TIMOTHY MICHAEL CLARK CRNA (NPI 1912017039) is an individual nurse anesthetist, certified registered in Tyler, Texas, licensed in Texas (074887) and active in the NPI registry since August 2006. He is affiliated with Christus Mother Frances Hospital and is a graduate of Other (2005).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 12
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Timothy Michael Clark Crna 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.
Medicare Billing Reassignments
4Medicare enrollment records show Timothy Clark reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Tyler, TX 75701
- Reassigned Medicare billing, Texas enrollment
- 547 clinicians in this Medicare group
Tyler, TX 75701
- Reassigned Medicare billing, Texas enrollment
- 6 clinicians in this Medicare group
Jacksonville, TX 75766
- Reassigned Medicare billing, Texas enrollment
- 409 clinicians in this Medicare group
Marshall, TX 75670
- Reassigned Medicare billing, Texas enrollment
- 106 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 2
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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Christus Mother Frances Hospital
Acute Care Hospitals · Tyler, TXPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 75701 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 Timothy Clark's NPI number?
The NPI number for Timothy Clark is 1912017039. It was assigned to this individual provider in the NPPES registry on August 30, 2006.
Where is Timothy Clark located?
Timothy Clark practices at 800 E Dawson St, Tyler, TX 75701. The listed phone number is (903) 531-2668.
What is Timothy Clark's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Timothy Clark enrolled in Medicare?
Yes. Timothy 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.
Which organizations bill Medicare for Timothy Clark's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Timothy Clark reassigns Medicare benefits to 4 organizations: Mother Frances Hospital Regional Health Care Center (Tyler, TX), Turtle Creek Surgery Center, LLC (Tyler, TX), Mother Frances Hospital Jacksonville (Jacksonville, TX) and Christus Good Shepherd Medical Center (Marshall, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Timothy Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Timothy Clark accept?
Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 2 other insurers list Timothy 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 Timothy Clark affiliated with any hospitals?
According to CMS data, Timothy Clark is affiliated with Christus Mother Frances Hospital.
When was this NPI record last updated?
The NPPES record for Timothy Clark was last updated on October 23, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Timothy Michael Clark, CRNA · NPI 1912017039
Nurse Anesthetist, Certified Registered physician in Tyler, Texas. Individual provider, active in the CMS NPPES registry since August 30, 2006.
## Identity
- **NPI:** 1912017039 (Entity type: Individual)
- **Enumerated:** August 30, 2006
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** 074887 (Texas)
- **Sole proprietor:** No
## Practice location
- **Address:** 800 E DAWSON ST, Tyler, TX 75701-2036
- **Phone:** (903) 531-2668
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Mother Frances Hospital Regional Health Care Center (NPI 1679578439, Tyler, TX); Turtle Creek Surgery Center, LLC (NPI 1437420270, Tyler, TX); Mother Frances Hospital Jacksonville (NPI 1952306672, Jacksonville, TX); Christus Good Shepherd Medical Center (NPI 1760908404, Marshall, TX) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2005
## Record status
- **NPPES last updated:** October 23, 2017
- **Other identifiers:** Medicare ID-Type Unspecified 8G4428 (TX); Medicare PIN 290420YSE3 (TX); Other 88839U (TX); and 9 more
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Source: [NPI Profile](https://npiprofile.com/npi/1912017039) · Data from the CMS NPPES public registry.