Mark Wilson Clancy, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA17808 Issued in TX

Practice address

110 Highway 290 W
Brenham, TX 77833-9165

Phone

(979) 830-5584

Fax

(979) 277-7100

NPI assigned

Jun 22, 2022

Last updated

Oct 9, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Joseph Regional Health CenterGroup PAC ID 5294727921, 141 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Accentcare Home Health of College Station Home health agency, College Station, TX, CCN 679189
• CHI St Joseph Health Regional Hospital Hospital, Bryan, TX, CCN 450011
• Bellville Medical Center Hospital, Bellville, TX, CCN 450253

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St. Joseph Regional Health Center

  • Family Medicine Physician
  • Bryan, TX
  • NPI 1669557179

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• St Joseph Regional Health Center

  dba St Joseph Franklin Family Medicine Clinic

  • Rural Health Clinic/Center
  • Franklin, TX
  • NPI 1780768911
  NPD
• College Station Hospital LP

  dba College Station Medical Center

  • Rehabilitation Hospital Unit
  • College Station, TX
  • NPI 1548286297
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bellville Medical Center

  dba Mid Coast Medical Center-Bellville

  • General Acute Care Hospital
  • Bellville, TX
  • NPI 1477857332
  Care Compare affiliation
• St Joseph Regional Health Center

  • General Acute Care Hospital
  • Bryan, TX
  • NPI 1942294939
  Care Compare affiliation
• St. Joseph Regional Health Center

  dba CHI St. Joseph Health College Station Hospital

  • General Acute Care Hospital
  • College Station, TX
  • NPI 1053963009
  Care Compare affiliation
• Texas Home Health Group of College Station, LLC

  dba AccentCare Home Health of College Station

  • Home Health Agency
  • College Station, TX
  • NPI 1720518178
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1609507334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HIGHWAY 290 W",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778339165",
            "telephone_number": "979-830-5584",
            "fax_number": "979-277-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HIGHWAY 290 W",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778339165",
            "telephone_number": "979-830-5584",
            "fax_number": "979-277-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 W University Dr",
            "address_purpose": "LOCATION",
            "city": "Edinburg",
            "state": "TX",
            "postal_code": "785392909",
            "country_code": "US",
            "telephone_number": "956-665-7049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLANCY",
        "first_name": "MARK",
        "middle_name": "WILSON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-22",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA17808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chappell Hill Behavioral Health
• Chappell Hill Personal Assistance Services LLC (Chappell Hill Home Health)
• Chappell Hill Personal Assistant Services
• Chayah Care, Inc.
• James Edward Chovanec, DDS
• Sherri L Clement, LCSW
• Robert G Cochran Jr., M.D.
• Robert Coghlan, NP
• Cognitrek Psychological & Counseling Services, PLLC
• College Station RHC Company LLC (Brenham Clinic)

• Physician Assistant in Brenham, TX
• Providers in Brenham, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.