Active NPI 1063660074 Individual Practitioner Male Practitioner

Nathaniel Clark , PA

Physician Assistant • Carbondale, IL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Nathaniel Clark, PA is a certified Physician Assistant practicing in Carbondale, IL. With approximately 18 years of clinical experience since completing medical education in 2008, Nathaniel Clark delivers high-quality medical care to the local community at 409 W OAK ST.

Nathaniel Clark is affiliated with Deaconess Illinois Specialty Clinic, Inc. and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, routine ekg using at least 12 leads including interpretation and report, routine electrocardiogram (ecg) using at least 12 leads with tracing. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

409 W Oak St

Carbondale, IL 629011464

Telephone 6185294455

Fax 6183511287

Medicare Profile & Education

Medical School

Other

Graduation Year

2008

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Carbondale, IL

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

18 Yrs +5.8 yrs vs City Avg

City Avg: 12.2 Yrs

State Avg: 11.7 Yrs

Regional Practice Density

71 Specialists

Practicing in Carbondale, IL (4958 Statewide)

Telehealth Adoption Rate

4.2% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

64.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Clark (18 Years) 18 Yrs

Carbondale Specialty Average (12.2 Years) 12.2 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
99213 Established patient office or other outpatient visit, typically 15 minutes	550	397	$171.31	$77.62
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	438	307	$244.13	$109.66
93000 Routine ekg using at least 12 leads including interpretation and report	333	245	$102.00	$12.09
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing	154	136	$49.00	$6.14
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	105	84	$193.20	$68.04
93016 Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician	57	57	$138.63	$17.78
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	56	45	$275.34	$103.52
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	49	47	$96.02	$48.04
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	25	25	$266.40	$95.92
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	18	18	$392.33	$145.48

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	317	275	$168.20	$74.93
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	317	255	$235.72	$105.56
93000 Routine ekg using at least 12 leads including interpretation and report	288	236	$102.00	$11.79
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	68	48	$190.00	$66.94
93016 Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician	49	49	$139.00	$17.22
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	29	25	$272.00	$100.70
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	26	26	$415.92	$139.04
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	20	20	$265.35	$89.79
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	18	18	$95.33	$46.64
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	14	13	$316.00	$149.06

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	340	316	$255.00	$106.00
99213 Established patient office or other outpatient visit, typically 15 minutes	260	252	$170.00	$75.39
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	66	66	$395.00	$137.20
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	66	66	$100.00	$47.04
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	39	36	$345.00	$151.09
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	35	35	$255.00	$92.05
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	18	15	$180.00	$59.68

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	317	308	$170.00	$75.95
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	266	251	$255.00	$107.52
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	104	103	$100.00	$46.58
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	84	84	$395.00	$141.16
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	56	56	$255.00	$94.12
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	31	30	$345.00	$151.91
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	17	15	$180.00	$60.54
99406 Smoking and tobacco use intermediate counseling, greater than 3 minutes up to 10 minutes	14	13	$30.00	$13.07

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	257	251	$255.00	$90.94
99213 Established patient office or other outpatient visit, typically 15 minutes	236	232	$170.00	$62.38
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	81	81	$396.17	$137.55
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	75	75	$256.00	$90.29
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	19	18	$180.00	$58.41
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	13	13	$100.00	$37.82

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	427	397	$170.00	$61.70
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	400	362	$255.00	$89.80
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	71	71	$395.00	$136.49
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	68	68	$255.00	$90.48
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	27	26	$345.00	$121.78
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	21	19	$180.00	$59.43

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	706	568	$170.00	$59.54
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	360	292	$255.00	$88.72
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	42	42	$255.00	$89.27
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	38	36	$345.00	$119.91
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	24	19	$180.00	$61.30
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	22	22	$100.00	$35.91

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	761	613	$169.09	$59.71
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	448	348	$253.37	$87.92
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	39	31	$180.00	$60.42
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	38	38	$255.00	$88.92
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	28	27	$345.00	$115.34
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	25	25	$100.00	$35.41
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	17	17	$395.00	$135.68
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	15	14	$340.00	$114.91
99231 Follow-up hospital inpatient care per day, typically 15 minutes	12	12	$100.00	$32.98

Medical Specialties & State Licenses

CMS Verified: 2022-12-21

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License IL 085003278

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Internal Medicine - Interventional Cardiology

NUCC Taxonomy Code: 207RI0011X

State License IL 085-003278

An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Railroad Medicare

P00657126 (IL)

Hospital & Practice Group Affiliations

Deaconess Illinois Specialty Clinic, Inc.

3333 W Deyoung St, Marion, IL 629595884

Phone: 6189987000

Deaconess Illinois Specialty Clinic, Inc.

3329 W Deyoung St, Marion, IL 629595884

Phone: 6189987177

Deaconess Illinois Specialty Clinic, Inc.

3331 W Deyoung St, Marion, IL 629595896

Phone: 6189987600

Deaconess Illinois Specialty Clinic, Inc.

303 S Commercial St, Harrisburg, IL 629462125

Phone: 6187676050

Secondary Practice Locations

3905 W Ernestine Dr

Marion, IL 629595800

Phone: 6185294455

100 Dr Warren Tuttle Dr

Harrisburg, IL 629462718

Phone: 6185294455

217 S Park Ave Ste 2

Herrin, IL 629483611

Phone: 6185294455

Practice Associates & Co-Workers

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

40 Associated Practitioners

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Doctor of Medicine (M.D.)

Meredith Flamm , PA-C

Physician Assistant

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Physician Assistant (Certified)

Dr. Cesar Coello , MD

Internal Medicine - Cardiovascular Disease

NPI 1003997560

Doctor of Medicine (M.D.)

Dr. Arslan Mirza , MD

Internal Medicine - Interventional Cardiology

NPI 1073928776

Doctor of Medicine (M.D.)

Dr. Vadzim Chyzhyk , MD

Internal Medicine - Cardiovascular Disease

NPI 1093128720

Doctor of Medicine (M.D.)

Dr. Firas Al Badarin , MD

Nuclear Medicine - Nuclear Cardiology

NPI 1093925737

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

10 Historical Events

📍

Updated Practice Location October 23, 2020

Registered at 409 W OAK ST, CARBONDALE, IL 629011464 (Tel: 6185294455)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) December 06, 2019

Internal Medicine (License #085-003278 in IL)

📍

Updated Business Mailing Address September 11, 2019

Registered at 409 W OAK ST, CARBONDALE, IL 629011464 (Tel: 6185294555)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 11, 2019

Physician Assistant (License #085003278 in IL)

✅

NPI Profile Active February 14, 2012

NPI status registered as active in NPPES database

📍

Updated Practice Location February 14, 2012

Registered at 409 W OAK ST, CARBONDALE, IL 629011414 (Tel: 6185294455)

📍

Updated Business Mailing Address February 14, 2012

Registered at PO BOX 1105, INDIANAPOLIS, IN 462061105 (Tel: 6185294455)

👤

Provider Name / Credentials Updated February 14, 2012

Recorded as NATHANIEL CLARK, P.A.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 14, 2012

Physician Assistant (License #085003278 in IL)

🟢

Initial NPI Registration & Enumeration September 03, 2008

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: 1063660074

Entity Type:

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

Enumeration Date: September 03, 2008

Last Update: December 21, 2022

Sole Proprietor: No

Update or Correct Profile

Mailing Address

409 W Oak St

Carbondale, IL 629011464

Phone: 6185294555

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

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