Active NPI 1366732729 Individual Practitioner Female Practitioner

Dr. Katelyn Ann Clark , MD

Surgery • Springfield, OR

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Katelyn Clark, MD is a certified Surgery practicing in Springfield, OR. With approximately 15 years of clinical experience since graduating from Oregon Health Sciences University School Of Medicine in 2011, Dr. Clark delivers high-quality medical care to the local community at PEACEHEALTH SURGICAL SPECIALTIES.

Dr. Clark maintains professional affiliations with Peacehealth Medical Group, Peacehealth and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include new patient outpatient office visit, established patient outpatient office visit, insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

Peacehealth Surgical Specialties
3355 Riverbend Dr., Suite 300

Springfield, OR 97477

Telephone 5412228333

Fax 5412228320

Medicare Profile & Education

Medical School

Oregon Health Sciences University School Of Medicine

Graduation Year

2011

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Springfield, OR

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

15 Yrs -7.0 yrs vs City Avg

City Avg: 22.0 Yrs

State Avg: 23.3 Yrs

Regional Practice Density

26 Specialists

Practicing in Springfield, OR (555 Statewide)

Telehealth Adoption Rate

30.8% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

62.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Clark (15 Years) 15 Yrs

Springfield Specialty Average (22.0 Years) 22.0 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
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	27	27	$549.07	$211.51
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	22	20	$310.36	$123.13
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	13	11	$441.77	$173.81
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	12	12	$941.75	$307.44
99213 Established patient office or other outpatient visit, typically 15 minutes	11	11	$208.00	$87.38
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	11	11	$406.18	$160.70
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	11	11	$52.45	$16.82

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	30	30	$468.07	$159.24
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	22	20	$331.45	$122.63
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	20	20	$618.60	$210.29
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	17	16	$448.65	$172.06

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	40	35	$332.00	$122.08
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	19	19	$501.00	$160.33
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	16	16	$422.00	$128.91
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	15	13	$446.00	$173.27

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	55	41	$332.00	$126.52
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	30	30	$501.00	$163.32
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	15	15	$422.00	$131.45
99221 Initial hospital inpatient care per day, typically 30 minutes	11	11	$312.00	$97.07

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	52	35	$332.40	$101.39
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	27	16	$222.56	$71.18
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	25	25	$422.12	$135.64
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	17	17	$501.88	$158.31
99231 Follow-up hospital inpatient care per day, typically 15 minutes	15	11	$121.13	$38.66
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	14	14	$622.79	$198.36
99213 Established patient office or other outpatient visit, typically 15 minutes	13	11	$228.00	$69.77

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	42	34	$326.67	$106.06
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	35	35	$413.66	$134.11
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	34	34	$611.06	$198.19
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	33	30	$219.88	$71.27
99213 Established patient office or other outpatient visit, typically 15 minutes	33	26	$222.64	$72.40
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	23	23	$500.70	$160.35
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	15	15	$327.73	$105.44
47563 Removal of gallbladder with x-ray study of bile ducts using an endoscope	11	11	$2139.73	$707.17

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	59	46	$201.86	$71.58
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	39	38	$562.62	$199.31
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	39	38	$289.00	$102.47
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	39	33	$297.74	$105.29
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	26	26	$453.50	$161.15
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	22	22	$378.82	$134.25
99213 Established patient office or other outpatient visit, typically 15 minutes	16	14	$201.63	$71.31
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	14	14	$296.50	$102.16

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	53	32	$209.66	$70.58
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	38	38	$587.21	$197.91
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	25	18	$303.00	$101.98
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	23	23	$396.74	$133.56
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	20	15	$126.05	$42.28
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	19	14	$311.11	$104.44
99213 Established patient office or other outpatient visit, typically 15 minutes	17	14	$210.94	$70.93
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	17	17	$311.47	$105.01

Medical Specialties & State Licenses

CMS Verified: 2022-11-29

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License OR MD175116

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

500654943 (OR)

Hospital & Practice Group Affiliations

Peacehealth Medical Group

3355 Riverbend Dr, Springfield, OR 974778800

Phone: 5412222402

Peacehealth

3377 Riverbend Dr, Springfield, OR 974778803

Phone: 5412222700

Secondary Practice Locations

3377 Riverbend Dr Ste 230

Springfield, OR 974778806

Phone: 5412222700

Practice Associates & Co-Workers

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

12 Associated Practitioners

Dr. Daniel Cusati , MD

Surgery

NPI 1134210370

Doctor of Medicine (M.D.)

Heidi Semple , NP

Nurse Practitioner - Family

NPI 1205355740

Nurse Practitioner

Chang Liu , PA-C

Physician Assistant

NPI 1205678745

Physician Assistant (Certified)

Dr. Nichole Ingalls , MD

Surgery

NPI 1235357104

Doctor of Medicine (M.D.)

Dr. Diego Muilenburg , MD

Surgery

NPI 1295716926

Doctor of Medicine (M.D.)

Dr. David Dehaas , MD

Surgery

NPI 1417986761

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

16 Historical Events

📍

Updated Practice Location February 28, 2024

Registered at PEACEHEALTH SURGICAL SPECIALTIES, 3355 RIVERBEND DR., SUITE 300, SPRINGFIELD, OR 97477 (Tel: 5412228333)

📍

Updated Business Mailing Address February 28, 2024

Registered at PEACEHEALTH SURGICAL SPECIALTIES, 3355 RIVERBEND DR., SUITE 300, SPRINGFIELD, OR 97477 (Tel: 5412228333)

📍

Updated Practice Location April 17, 2019

Registered at 3355 RIVERBEND DR STE 300, SPRINGFIELD, OR 974778800 (Tel: 5418689303)

📍

Updated Practice Location August 20, 2018

Registered at 3355 RIVERBEND DR, SUITE 300, SPRINGFIELD, OR 97477 (Tel: 5418689303)

📍

Updated Business Mailing Address April 12, 2018

Registered at 3355 RIVERBEND DR STE 300, SPRINGFIELD, OR 974778800 (Tel: 5418689340)

✅

NPI Profile Active September 25, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location September 25, 2017

Registered at 3355 RIVERBEND DR, SUITE 300, SPRINGFIELD, OR 974778800 (Tel: 5418689352)

📍

Updated Business Mailing Address September 25, 2017

Registered at 3355 RIVERBEND DR, SUITE 300, SPRINGFIELD, OR 974778800 (Tel: 5418689352)

👤

Provider Name / Credentials Updated September 25, 2017

Recorded as KATELYN CLARK, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 25, 2017

Surgery (License #MD175116 in OR)

✅

NPI Profile Active August 19, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location August 19, 2016

Registered at 3355 RIVERBEND DR, SUITE 300, SPRINGFIELD, OR 974778800 (Tel: 5418689352)

📍

Updated Business Mailing Address August 19, 2016

Registered at 3355 RIVERBEND DR, SUITE 300, SPRINGFIELD, OR 974778800 (Tel: 5418689352)

👤

Provider Name / Credentials Updated August 19, 2016

Recorded as KATELYN CLARK, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) August 19, 2016

Surgery (License #MD175116 in OR)

🟢

Initial NPI Registration & Enumeration April 19, 2011

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1366732729

Entity Type:

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

Enumeration Date: April 19, 2011

Last Update: February 28, 2024

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

Peacehealth Surgical Specialties, 3355 Riverbend Dr., Suite 300

Springfield, OR 97477

Phone: 5412228333

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.