Active NPI 1902992837 Individual Practitioner Male Practitioner

Dr. Jack O. Clark , MD

Internal Medicine • Rexburg, ID

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Jack Clark, MD is a certified Internal Medicine practicing in Rexburg, ID. With approximately 27 years of clinical experience since graduating from Pennsylvania State University College Of Medicine in 1999, Dr. Clark delivers high-quality medical care to the local community at 450 E MAIN ST.

Dr. Clark maintains professional affiliations with Madison Memorial Hospital, Madison Co Memorial Hospital and accepts Medicare assignment.

Frequently performed procedures and clinical services include subsequent hospital care with moderate levelof medical decision making, if using time, at least, hospital discharge day management, more than, initial hospital care with moderate level of medical decision making, if using time, at least. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

450 E Main St

Rexburg, ID 83440

Telephone 2083596419

Fax 2083563111

Associated Practice Facility / Clinic

🏢 Madison Physician Services Facility NPI 1639111206

Medicare Profile & Education

Medical School

Pennsylvania State University College Of Medicine

Graduation Year

1999

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Rexburg, ID

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

27 Yrs +6.0 yrs vs City Avg

City Avg: 21.0 Yrs

State Avg: 22.9 Yrs

Regional Practice Density

5 Specialists

Practicing in Rexburg, ID (472 Statewide)

Telehealth Adoption Rate

20.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

59.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Clark (27 Years) 27 Yrs

Rexburg Specialty Average (21.0 Years) 21.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	65	45	$150.03	$72.75
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	46	34	$214.00	$109.49
99239 Hospital discharge day management, more than 30 minutes	42	39	$219.00	$105.58
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	29	28	$409.38	$160.13
99291 Critical care, first 30-74 minutes	18	15	$663.00	$195.93
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	18	18	$280.00	$119.94
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	17	16	$141.00	$70.70
94016 Physician interpretation and report of measurement and graphic recording of amount and speed of breathed air over 30-day period	16	16	$50.00	$22.78

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	87	45	$214.00	$112.72
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	84	45	$148.00	$74.91
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	59	34	$141.00	$69.87
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	50	47	$265.00	$125.75
94016 Physician interpretation and report of measurement and graphic recording of amount and speed of breathed air over 30-day period	41	40	$50.00	$23.42
99306 Initial nursing facility visit, typically 45 minutes per day	41	38	$340.00	$172.40
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	40	36	$414.00	$164.32
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	39	21	$186.00	$100.60
99239 Hospital discharge day management, more than 30 minutes	37	37	$219.00	$108.03
99291 Critical care, first 30-74 minutes	31	20	$663.00	$201.27
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	22	22	$280.00	$122.83
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	18	13	$91.00	$37.39

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	126	54	$180.62	$84.81
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	99	63	$203.01	$96.02
99306 Initial nursing facility visit, typically 45 minutes per day	87	80	$333.10	$154.67
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	76	45	$137.25	$64.04
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	66	44	$139.17	$66.92
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	55	52	$390.55	$183.62
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	51	47	$258.88	$120.80
99239 Hospital discharge day management, more than 30 minutes	47	44	$209.13	$98.36
99291 Critical care, first 30-74 minutes	32	21	$560.56	$204.70
94016 Physician interpretation and report of measurement and graphic recording of amount and speed of breathed air over 30-day period	31	30	$49.23	$23.12
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	26	20	$269.04	$125.57
99217 Hospital observation care on day of discharge	16	16	$139.06	$66.76
99220 Hospital observation care, typically 70 minutes	15	15	$356.73	$167.77

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	142	82	$137.00	$67.92
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	107	43	$176.34	$85.42
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	88	54	$198.00	$97.66
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	87	42	$133.59	$64.51
99239 Hospital discharge day management, more than 30 minutes	70	70	$203.00	$100.17
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	67	61	$251.09	$121.98
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	59	56	$384.00	$189.10
94016 Physician interpretation and report of measurement and graphic recording of amount and speed of breathed air over 30-day period	52	50	$49.00	$24.13
99306 Initial nursing facility visit, typically 45 minutes per day	49	47	$324.86	$156.89
99291 Critical care, first 30-74 minutes	48	30	$514.00	$208.03
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	24	19	$263.50	$126.93
99217 Hospital observation care on day of discharge	24	24	$137.00	$67.91
99220 Hospital observation care, typically 70 minutes	19	19	$353.00	$171.99
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	18	18	$259.00	$128.05
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	14	12	$85.71	$41.25

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	176	105	$150.00	$69.40
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	132	77	$213.69	$99.96
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	84	80	$417.68	$193.30
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	76	68	$187.53	$124.05
99239 Hospital discharge day management, more than 30 minutes	73	68	$219.16	$102.12
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	70	36	$130.00	$65.82
99291 Critical care, first 30-74 minutes	64	31	$486.50	$213.00
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	52	29	$122.04	$85.66
94016 Physician interpretation and report of measurement and graphic recording of amount and speed of breathed air over 30-day period	51	50	$45.55	$24.81
99217 Hospital observation care on day of discharge	25	25	$152.84	$69.18
99238 Hospital discharge day management, 30 minutes or less	25	25	$146.88	$67.62
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	24	17	$84.00	$41.94
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	24	23	$172.00	$86.03
99306 Initial nursing facility visit, typically 45 minutes per day	24	23	$315.08	$160.02
99220 Hospital observation care, typically 70 minutes	20	20	$385.30	$176.61
99292 Critical care, each additional 30 minutes	17	11	$236.82	$107.10
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	14	14	$285.57	$130.87

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	185	103	$217.00	$97.95
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	174	105	$153.00	$69.02
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	92	86	$425.00	$190.34
99239 Hospital discharge day management, more than 30 minutes	89	82	$223.00	$101.55
94016 Physician interpretation and report of measurement and graphic recording of amount and speed of breathed air over 30-day period	61	60	$45.00	$24.56
99217 Hospital observation care on day of discharge	45	45	$155.27	$68.11
99238 Hospital discharge day management, 30 minutes or less	40	39	$150.00	$67.83
99291 Critical care, first 30-74 minutes	37	15	$470.00	$211.13
99220 Hospital observation care, typically 70 minutes	37	37	$387.00	$176.20
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	23	23	$290.00	$129.63
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	21	19	$130.00	$65.44
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	20	19	$246.00	$124.22
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	18	14	$151.00	$87.01
99219 Hospital observation care, typically 50 minutes	13	13	$280.00	$128.92

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	158	97	$153.00	$67.19
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	142	81	$217.00	$96.28
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	110	107	$425.00	$187.01
99239 Hospital discharge day management, more than 30 minutes	80	78	$223.00	$99.32
94016 Physician interpretation and report of measurement and graphic recording of amount and speed of breathed air over 30-day period	48	48	$45.00	$23.79
99220 Hospital observation care, typically 70 minutes	42	41	$387.00	$171.97
99217 Hospital observation care on day of discharge	40	38	$155.00	$67.27
99231 Follow-up hospital inpatient care per day, typically 15 minutes	36	25	$84.00	$36.15
99238 Hospital discharge day management, 30 minutes or less	32	32	$150.00	$67.27
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	11	11	$290.00	$125.91

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	333	164	$261.14	$95.41
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	269	147	$178.95	$65.98
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	168	160	$505.07	$183.90
99239 Hospital discharge day management, more than 30 minutes	134	127	$263.72	$97.59
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	57	46	$241.00	$83.65
99220 Hospital observation care, typically 70 minutes	47	47	$475.79	$170.56
99217 Hospital observation care on day of discharge	31	31	$177.06	$66.28
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	30	25	$182.00	$63.09
99238 Hospital discharge day management, 30 minutes or less	25	25	$171.12	$65.97
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	20	20	$327.00	$124.45
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	16	16	$346.00	$119.50
99291 Critical care, first 30-74 minutes	15	11	$520.40	$203.10
99219 Hospital observation care, typically 50 minutes	15	15	$339.40	$124.48

Medical Specialties & State Licenses

CMS Verified: 2020-04-13

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License ID M-7743

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

114780300 (WY)

Medicaid State Provider ID

80633500 (ID)

Medicaid State Provider ID

805499200 (ID)

Commercial Insurance / Payer ID Regence Bcbs Idaho

10018055 (ID)

Commercial Insurance / Payer ID Blue Cross Idaho

58289 (ID)

Hospital & Practice Group Affiliations

Madison Memorial Hospital

450 E Main St, Reburg, ID 834402048

Phone: 2083596516

Madison Co Memorial Hospital

37 S 2nd, Rexburg, ID 834401906

Phone: 2083560234

Secondary Practice Locations

166 S 5th St, Suite B

Montpelier, ID 832541557

Phone: 2088471110

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners

Adriann Wilcox , FNP

Nurse Practitioner

NPI 1003312489

Family Nurse Practitioner

Rebecca Perez , PA-C

Physician Assistant

NPI 1154618601

Physician Assistant (Certified)

Dr. Matheau Eysser , DO

Orthopaedic Surgery

NPI 1356629885

Doctor of Osteopathic Medicine (D.O.)

Zachery Brunson , PA-C

Physician Assistant - Medical

NPI 1447296785

Physician Assistant (Certified)

Dr. Charles Zollinger , MD

General Practice

NPI 1629182282

Doctor of Medicine (M.D.)

Rex Meredith , PA-C

Physician Assistant - Medical

NPI 1780965038

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

📍

Updated Practice Location September 12, 2019

Registered at 450 E MAIN ST, REXBURG, ID 83440 (Tel: 2083596419)

📍

Updated Business Mailing Address September 12, 2019

Registered at 450 E MAIN ST, REXBURG, ID 834402048 (Tel: 2083596419)

✅

NPI Profile Active April 08, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location April 08, 2015

Registered at 166 S 5TH ST, SUITE B, MONTPELIER, ID 832541557 (Tel: 2088471110)

📍

Updated Business Mailing Address April 08, 2015

Registered at 166 S 5TH ST, SUITE B PO BOX 69, MONTPELIER, ID 832541557 (Tel: 2088471100)

👤

Provider Name / Credentials Updated April 08, 2015

Recorded as JACK CLARK, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 08, 2015

Internal Medicine (License #M-7743 in ID)

🟢

Initial NPI Registration & Enumeration October 05, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1902992837

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: October 05, 2006

Last Update: April 13, 2020

Sole Proprietor: No

Update or Correct Profile

Mailing Address

450 E Main St

Rexburg, ID 834402048

Phone: 2083596419

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.