Timothy Pat Clary, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

15-00296 Issued in KS

Practice address

5325 Faraon St
Saint Joseph, MO 64506-3488

Phone

(816) 271-6122

Fax

(816) 271-6019

NPI assigned

Apr 5, 2006

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO, TX2 enrollments

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 2

Specialty

Physician Assistant

Education

University of Nebraska College of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

White Cloud Health Center LLCGroup PAC ID 9830437995, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hiawatha Community Hospital Hospital, Hiawatha, KS, CCN 171341

Merit-based Incentive Payment System (MIPS)

Final score

87.36 of 100Reported as group

Quality

81.83

Promoting interoperability

99

Improvement activities

40

Cost

74.61

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• White Cloud Health Center, LLC

  • Clinic/Center
  • White Cloud, KS
  • NPI 1407327620

  TX

  Medicare reassignment Care Compare group
• Heartland Regional Medical Center

  dba Mosaic Life Care

  • General Practice Physician
  • Saint Joseph, MO
  • NPI 1477575405
  Medicare reassignment NPD
• Heartland Regional Medical Center

  dba Mosaic Life Care at St. Joseph Acute Rehab

  • Rehabilitation Hospital Unit
  • Saint Joseph, MO
  • NPI 1841385093
  NPD
• White Cloud Health Center, LLC

  dba Pharmacy - White Cloud Health Center, LLC

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • White Cloud, KS
  • NPI 1194288480
  NPD (past)

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

• Hiawatha Hospital Association Inc

  dba Amberwell Hiawatha

  • Critical Access Hospital
  • Hiawatha, KS
  • NPI 1255421210
  Care Compare affiliation

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1750343695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5325 FARAON ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063488",
            "telephone_number": "816-271-6122",
            "fax_number": "816-271-6019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 FARAON ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063488",
            "telephone_number": "816-271-6122",
            "fax_number": "816-271-6019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 W. 18th St.",
            "address_purpose": "LOCATION",
            "city": "Hornton",
            "state": "KS",
            "postal_code": "66439",
            "country_code": "US",
            "telephone_number": "785-486-2642",
            "fax_number": "785-486-2736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARY",
        "first_name": "TIMOTHY",
        "middle_name": "PAT",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KS",
            "license": "15-00296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT",
            "identifier": "042G3",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexavier Maximus Clark
• Heather Elise Clark, DDS
• Robert C Clark, M.D.
• Vickie J Clark, MSW PLCSW
• Tennyson Clary, LMSW, CADC, SQP
• Conlyn Taylor Clay
• Stephanie Renee Cline, PTA
• Sarah Clingan
• Christina Coalter, PHARMD
• Jessica Louise Cobb

• Medical Physician Assistant in Saint Joseph, MO
• Providers in Saint Joseph, MO by specialty
• Medical Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.