Katelyn Ann Clark, MD - Medicare General Surgery in Springfield, OR

Katelyn Ann Clark, MD is a medicare enrolled "Surgery" physician in Springfield, Oregon. She went to Oregon Health Sciences University School Of Medicine and graduated in 2011 and has 13 years of diverse experience with area of expertise as General Surgery. She is a member of the group practice Peacehealth, Peacehealth Medical Group and her current practice location is Peacehealth Surgical Specialties, 3355 Riverbend Dr., Suite 300, Springfield, Oregon. You can reach out to her office (for appointments etc.) via phone at (541) 222-8333.

Katelyn Ann Clark is licensed to practice in Oregon (license number MD175116) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1366732729.

Contact Information

Katelyn Ann Clark, MD
Peacehealth Surgical Specialties, 3355 Riverbend Dr., Suite 300,
Springfield, OR 97477
(541) 222-8333
(541) 222-8320



Physician's Profile

Full NameKatelyn Ann Clark
GenderFemale
SpecialityGeneral Surgery
Experience13 Years
LocationPeacehealth Surgical Specialties, Springfield, Oregon
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Katelyn Ann Clark attended and graduated from Oregon Health Sciences University School Of Medicine in 2011
  NPI Data:
  • NPI Number: 1366732729
  • Provider Enumeration Date: 04/19/2011
  • Last Update Date: 02/28/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 7911143201
  • Enrollment ID: I20160727000078

Medical Identifiers

Medical identifiers for Katelyn Ann Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1366732729NPI-NPPES
500654943MedicaidOR

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208600000XSurgery MD175116 (Oregon)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Sacred Heart Medical Center - RiverbendSpringfield, ORHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Peacehealth8527016039174
Peacehealth Medical Group9032023270206

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Katelyn Ann Clark allows following entities to bill medicare on her behalf.
Entity NamePeacehealth Medical Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1447207287
PECOS PAC ID: 9032023270
Enrollment ID: O20031113000097

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Entity NameNorthwest Surgical Specialists Llp
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1770516544
PECOS PAC ID: 9032009493
Enrollment ID: O20040318000836

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Entity NamePeacehealth
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1740223874
PECOS PAC ID: 8527016039
Enrollment ID: O20050111000353

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Katelyn Ann Clark is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Katelyn Ann Clark, MD
Peacehealth Surgical Specialties, 3355 Riverbend Dr., Suite 300,
Springfield, OR 97477

Ph: (541) 222-8333
Katelyn Ann Clark, MD
Peacehealth Surgical Specialties, 3355 Riverbend Dr., Suite 300,
Springfield, OR 97477

Ph: (541) 222-8333

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Surgery Doctors in Springfield, OR

Dr. Jose Viramontes Jr., M.D.
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 1460 G St Ste 100, Springfield, OR 97477
Phone: 541-988-6330    Fax: 541-988-6340
Dr. Snell Fontus, MD
Surgery
Medicare: Medicare Enrolled
Practice Location: 1881 2nd St, Ste 201, Springfield, OR 97477
Phone: 541-684-4716    Fax: 541-683-9790
Dr. Paul S. Koh, MD
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 3311 Riverbend Drive, Springfield, OR 97477
Phone: 541-222-2866    Fax: 541-222-2843
Daniel A Cusati, M.D.
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: Peacehealth Surgical Specialties, 3355 Riverbend Dr., Suite 300, Springfield, OR 97477
Phone: 541-222-8333    Fax: 541-222-8320
Dr. Warren M Glover, M.D.
Surgery
Medicare: Not Enrolled in Medicare
Practice Location: 3311 Riverbend Dr, Springfield, OR 97477
Phone: 541-222-3531    Fax: 541-222-2843
Winnie W. Henderson, M.D., PH.D.
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 3783 International Ct Ste 200, Springfield, OR 97477
Phone: 541-735-3778    Fax: 541-735-3772
Nichole Ingalls, MD
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: Peacehealth Surgical Specialties, 3355 Riverbend Dr Ste 300, Springfield, OR 97477
Phone: 541-222-8333    Fax: 541-222-8320

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