Clark A. Elliott, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

12266 Issued in ND

Practice address

1104 Cass St
Traverse City, MI 49684-3236

Phone

(231) 941-1155

Fax

(231) 259-1005

NPI assigned

May 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY, MI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Otolaryngology

Education

University of Manitoba, Faculty of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Richard C Schultz MD and Associates PCGroup PAC ID 7719171966, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Munson Medical Center Hospital, Traverse City, MI, CCN 230097
• Munson Healthcare Otsego Memorial Hospital Hospital, Gaylord, MI, CCN 230133
• Paul Oliver Memorial Hospital Hospital, Frankfort, MI, CCN 231300

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Richard C Schultz MD & Associates PC

  • Otolaryngology Physician
  • Traverse City, MI
  • NPI 1437255254
  Medicare reassignment Care Compare group NPD
• Our Lady of Lourdes Memorial Hospital Inc.

  • General Acute Care Hospital
  • Binghamton, NY
  • NPI 1629087580
  Medicare reassignment NPD
• Our Lady of Lourdes Memorial Hospital, Inc.

  • Family Medicine Physician
  • Binghamton, NY
  • NPI 1063557189
  NPD
• Our Lady of Lourdes Memorial Hospital, Inc.

  • Specialty Pharmacy
  • Johnson City, NY
  • NPI 1730982596
  NPD

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

• Munson Healthcare Otsego Memorial Hospital

  • General Acute Care Hospital
  • Gaylord, MI
  • NPI 1124028972
  Care Compare affiliation
• Munson Medical Center

  • General Acute Care Hospital
  • Traverse City, MI
  • NPI 1952307852
  Care Compare affiliation
• Paul Oliver Memorial Hospital

  • Critical Access Hospital
  • Frankfort, MI
  • NPI 1427054360
  Care Compare affiliation

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1871540567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 CASS ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496843236",
            "telephone_number": "231-941-1155",
            "fax_number": "231-259-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 CASS ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496843236",
            "telephone_number": "231-941-1155",
            "fax_number": "231-259-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "CLARK",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-28",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "KY",
            "license": "41717",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "KY",
            "license": "41717",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "ND",
            "license": "12266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "celliott58@cassstearnosethroat.ema.md",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1104 Cass St",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496843236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elite Physical Therapy and Sports Performance
• Elizabeth G Bruning PHD PLLC
• Elizabeth McDonald Professional Counseling, LLC
• Amy Elkins
• Elizabeth Shannon Elliot, D.O.
• Mark A Elliott, M.D.
• Alexandra Ellis
• Charlotte Lynn Ellis, PA
• Stephanie Ellis
• Katherine Renee Elms, M.D.

• Otolaryngology Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Otolaryngology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.