KRISTIN ELISE CLARK MD
NPI 1164764585
Anesthesiology in Plymouth, MN
NPI Status: Active since March 24, 2013
Contact Information
14700 28TH AVE N STE 20
PLYMOUTH, MN
ZIP 55447
Phone: (763) 559-3779
Fax: (763) 450-3986
- Individual
- Female
- Anesthesiology
- Accepts Insurance
- PECOS Enrolled
About KRISTIN CLARK
This page provides the complete NPI Profile along with additional information for Kristin Clark, an anesthesiologist established in Plymouth, Minnesota with a medical specialization in Anesthesiology. The healthcare provider is registered in the NPI registry with number 1164764585 assigned on March 2013. The practitioner's primary taxonomy code is 207L00000X with license number 64496 (MN). The provider is registered as an individual and her NPI record was last updated 7 years ago.
- NPI
- 1164764585
- Provider Name
- KRISTIN ELISE CLARK MD
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 14700 28TH AVE N STE 20 PLYMOUTH, MN 55447
- Location Phone
- (763) 559-3779
- Location Fax
- (763) 450-3986
- Mailing Address
- PO BOX 47159 PLYMOUTH, MN 55447
- Mailing Phone
- (763) 559-3779
- Mailing Fax
- (763) 450-3986
- Is Sole Proprietor?
- No
- Enumeration Date
- 03-24-2013
- Last Update Date
- 09-26-2018
- Code Navigator
An anesthesiologist like Kristin Clark manages the care of surgical patients and pain relief through drug administration that reduces or eliminates pain during an operation, medical procedure or during labor and delivery of babies. During surgical procedures anesthesiologists are responsible for adjusting the amount of anesthetic, monitoring the patient's heart rate, body temperature, blood pressure and breathing.
Location Map
Secondary Locations
- 8701 W Watertown Plank Rd
Milwaukee, WI 53226
(414) 955-4575
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Anesthesiology
- Taxonomy Code
- 207L00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 64496
- License State
- MN
- Taxonomy Description
- An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
- Medica Individual Choice Bronze HSA - EPO
- Medica Individual Choice Bronze Share - EPO
- Medica Individual Choice Bronze Share - HMO
- Medica Individual Choice Expanded Bronze Standard - EPO
- Medica Individual Choice Expanded Bronze Standard - HMO
- Medica Individual Choice Gold $0 Copay PCP Visits - EPO
- Medica Individual Choice Gold $0 Copay PCP Visits - HMO
- Medica Individual Choice Gold Share - EPO
- Medica Individual Choice Gold Share - HMO
- Medica Individual Choice Gold Standard - EPO
- Medica Individual Choice Gold Standard - HMO
- Medica Individual Choice Silver $0 Copay PCP Visits - EPO
- Medica Individual Choice Silver $0 Copay PCP Visits - HMO
- Medica Individual Choice Silver Share - EPO
- Medica Individual Choice Silver Share - HMO
- Medica Individual Choice Silver Standard - EPO
- Medica Individual Choice Silver Standard - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Kristin Clark is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Reviews for KRISTIN ELISE CLARK MD
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 6 | 4 | 7 | 6 | 4 | 5 | 8 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 12 | 4 | 14 | 6 | 8 | 5 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 2 + 4 + 1 + 4 + 6 + 8 + 5 + 1 + 6 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1164764585 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1588778179 | DR. KELLY B. KROMER MD Individual | Anesthesiology | 14700 28TH AVE N STE 20 PLYMOUTH, MN 55447 (763) 852-0435 |
| 1306993100 | JASON OLINGER MD Individual | Anesthesiology | 14700 28TH AVE N STE 20 PLYMOUTH, MN 55447 (952) 428-2477 |
| 1386633576 | DR. ANDREW SEDIVY MD Individual | Anesthesiology | 14700 28TH AVE N STE 20 PLYMOUTH, MN 55447 (763) 852-0435 |
| 1326483132 | DRAGANA URDAREVIK MD Individual | Anesthesiology | 14700 28TH AVE N STE 20 PLYMOUTH, MN 55447 (763) 852-0435 |
| 1477072247 | JOSHUA MICHAEL KENZIE CRNA Individual | Nurse Anesthetist, Certified Registered | 14700 28TH AVE N STE 20 PLYMOUTH, MN 55447 (763) 852-0435 |
| 1073013462 | DILLON JOSEPH DRYJA CRNA Individual | Nurse Anesthetist, Certified Registered | 14700 28TH AVE N STE 20 PLYMOUTH, MN 55447 (763) 852-0411 |
| 1376869917 | JOHN D JOCHMAN M.D. Individual | Anesthesiology | 14700 28TH AVE N STE 20 PLYMOUTH, MN 55447 (763) 559-3779 |
| 1487882395 | ADAM D. CURRIER MD Individual | Anesthesiology | 14700 28TH AVE N STE 20 PLYMOUTH, MN 55447 (763) 559-3779 |
| 1831618859 | ANDREW PAUL DICKMAN Individual | Nurse Anesthetist, Certified Registered | 14700 28TH AVE N STE 20 PLYMOUTH, MN 55447 (763) 559-3779 |
| 1407375967 | ADAM JOSEPH DICKMAN CRNA Individual | Nurse Anesthetist, Certified Registered | 14700 28TH AVE N STE 20 PLYMOUTH, MN 55447 (763) 559-3779 |
| 1114438488 | MR. JOHN A CAMBEST CRNA Individual | Nurse Anesthetist, Certified Registered | 14700 28TH AVE N STE 20 PLYMOUTH, MN 55447 (763) 852-0435 |
| 1841618154 | THOMAS ESSER D.O. Individual | Anesthesiology | 14700 28TH AVE N STE 20 PLYMOUTH, MN 55447 (763) 559-3779 |
| 1750797551 | MATTHEW MOLDAN M.D. Individual | Anesthesiology | 14700 28TH AVE N STE 20 PLYMOUTH, MN 55447 (763) 559-3779 |
| 1770901803 | DR. MICHAEL JAMES POTTER M.D. Individual | Anesthesiology | 14700 28TH AVE N STE 20 PLYMOUTH, MN 55447 (763) 559-3779 |
| 1801370358 | LEAH MOORE Individual | Nurse Anesthetist, Certified Registered | 14700 28TH AVE N STE 20 PLYMOUTH, MN 55447 (763) 559-3779 |
| 1821090564 | KARIN KENYON CRNA Individual | Nurse Anesthetist, Certified Registered | 14700 28TH AVE N STE 20 PLYMOUTH, MN 55447 (763) 559-3779 |
| 1609361609 | ASHLEY ANN DICK Individual | Nurse Anesthetist, Certified Registered | 14700 28TH AVE N STE 20 PLYMOUTH, MN 55447 (763) 559-3779 |
| 1558335562 | MELANIE A HALL CRNA Individual | Nurse Anesthetist, Certified Registered | 14700 28TH AVE N STE 20 PLYMOUTH, MN 55447 (763) 559-3779 |
| 1083151591 | MOWOH A ENDELEY CRNA Individual | Nurse Anesthetist, Certified Registered | 14700 28TH AVE N STE 20 PLYMOUTH, MN 55447 (763) 559-3779 |
| 1447646864 | PETER D HUGHES M.D. Individual | Anesthesiology | 14700 28TH AVE N STE 20 PLYMOUTH, MN 55447 (763) 559-3779 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1164764585, enumerated in the NPI registry as an "individual" on March 24, 2013
The provider is located at 14700 28th Ave N Ste 20 Plymouth, Mn 55447 and the phone number is (763) 559-3779
The provider's speciality is Anesthesiology with taxonomy code 207L00000X
The provider might be accepting Accepts: Medica. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
This NPI record was last updated on March 24, 2013. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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