NATHANIEL CLARK (P.A.) – Physician Assistant, NPI 1063660074
Physician Assistant
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for NATHANIEL CLARK (P.A.)
409, West Oak Street, Carbondale, Jackson County, Illinois, 62901, United States
CARBONDALE, IL 629011464
Phone: (618) 529-4555
Fax: (618) 351-1287
Type: Mailing
3905 W Ernestine Dr
Marion, IL 629595800
Phone: (618) 529-4455
Fax: (618) 351-1287
Type: Location
100 Dr Warren Tuttle Dr
Harrisburg, IL 629462718
Phone: (618) 529-4455
Fax: (618) 351-1287
Type: Location
217 S Park Ave Ste 2
Herrin, IL 629483611
Phone: (618) 529-4455
Fax: (618) 351-1287
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 165 Open Payments records for all available years, with a total value of $3,376.
Total Amount is formed as General ($3,376) + Research ($0) + Ownership ($0) = $3,376.
Last reported payment date: 2024-12-16 • Largest payer in this snapshot: Novartis Pharmaceuticals Corporation ($460).
Total Amount
$3,376
General + Research + Ownership
Payments
165
Total payment records
General Amount
$3,376
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-16
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2008-10-08
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20081008000708 | I | Physician Assistant | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 317 | 275 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 317 | 255 | $0 |
| 93000 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | 288 | 236 | $0 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 68 | 48 | $0 |
| 93016 | Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician | 49 | 49 | $0 |
Insurance plans in this area (ZIP 62901)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Hospitalist, Family Practice | IL | |
| Hospitalist, Internal Medicine | IL | |
| Pulmonary Disease | NM | |
| Internal Medicine, Family Practice | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| H E M A T O L O G Y/ O N C O L O G Y | IL | |
| H O S P I T A L I S T | MO | |
| Neurology, Critical Care (Intensivists) | IN | |
| Physician Assistant | IL |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.