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Active NPI 1003683509 Individual Practitioner Female Practitioner

Katherine Rose Clark , PA-C

Physician Assistant • Crystal, MN

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Katherine Clark, PA-C is a certified Physician Assistant practicing in Crystal, MN. With approximately 3 years of clinical experience since graduating from Touro Un Col Of Osteopathic Medicine, Henderson in 2023, Katherine Clark delivers high-quality medical care to the local community at 5109 36TH AVE N.

Katherine Clark is affiliated with North Clinic Pa and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

5109 36th Ave N

Crystal, MN 55422

Telephone 7635877999
Fax 7635877989
Associated Practice Facility / Clinic
🏢 North Clinic, Pa Facility NPI 1134374523

Medicare Profile & Education

Medical School

Touro Un Col Of Osteopathic Medicine, Henderson

Graduation Year

2023

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Crystal, MN

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
3 Yrs -11.3 yrs vs City Avg
City Avg: 14.3 Yrs
State Avg: 10.9 Yrs
Regional Practice Density
8 Specialists

Practicing in Crystal, MN (4026 Statewide)

Telehealth Adoption Rate
25.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
75.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Clark (3 Years) 3 Yrs
Crystal Specialty Average (14.3 Years) 14.3 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes
73 69 $300.00 $74.96
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
18 16 $425.00 $105.79

Medical Specialties & State Licenses

CMS Verified: 2025-03-26
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License MN 14744

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.

Hospital & Practice Group Affiliations

North Clinic Pa

5109 36th Ave N, Crystal, MN 554222007

Phone: 7635877900

North Clinic Pa

50 Central Ave, Osseo, MN 553691241

Phone: 7635877900

Secondary Practice Locations

9825 Hospital Dr Ste 300

Maple Grove, MN 553694768

Phone: 7635877999

Practice Associates & Co-Workers

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

34 Associated Practitioners
Dr. Caitlin Kuck , MD

Obstetrics & Gynecology

NPI 1033521059

Doctor of Medicine (M.D.)

Kenan Guilmette , PA-C

Physician Assistant

NPI 1093023152

Physician Assistant (Certified)

Dr. Janette Withers , MD

Internal Medicine

NPI 1205853108

Doctor of Medicine (M.D.)

Dr. Frederic Nemer , MD

Colon & Rectal Surgery

NPI 1225046063

Doctor of Medicine (M.D.)

Jessica Rusciano

Nurse Practitioner - Women's Health

NPI 1235020355
Dr. Nicholas Schneeman , MD

Family Medicine - Geriatric Medicine

NPI 1245269612

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

9 Historical Events
📍
Updated Practice Location March 31, 2025

Registered at 5109 36TH AVE N, CRYSTAL, MN 55422 (Tel: 7635877999)

📍
Updated Business Mailing Address March 31, 2025

Registered at 5109 36TH AVE N, CRYSTAL, MN 55422 (Tel: 7635877999)

👤
Provider Name / Credentials Updated March 31, 2025

Recorded as KATHERINE CLARK, PA-C

NPI Profile Active December 05, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location December 05, 2023

Registered at 5109 36TH AVE N, CRYSTAL, MN 554222007 (Tel: 7635877999)

📍
Updated Business Mailing Address December 05, 2023

Registered at 601 SE MAIN ST APT 202, MINNEAPOLIS, MN 554142953

👤
Provider Name / Credentials Updated December 05, 2023

Recorded as KATHERINE MATTINEN, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 05, 2023

Physician Assistant (License #14744 in MN)

🟢
Initial NPI Registration & Enumeration December 05, 2023

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: 1003683509
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 05, 2023
Last Update: March 31, 2025
Sole Proprietor: No

Mailing Address

5109 36th Ave N

Crystal, MN 55422

Phone: 7635877999

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.