Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jimmy Clark Jr., PA-C

Individual provider Physician Assistant · NPI 1891164372

Jimmy Clark Jr., PA-C is a Physician Assistant in Madison, Wisconsin. Qualified in 2015, 11 years ago. Practices with Stoughton Hospital Association, a 66-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
11
Licensed in
WI
In the registry since
2015
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

5512 Spring Tide Way
Madison, WI 53718-9125
Phone: (224) 848-0612
Show map & directions

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 3614 (WI)

Record details

NPI number1891164372
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 15, 2015
Last updated in NPPESJune 9, 2026
Certification dateJune 9, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Stoughton Hospital Association — 66 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients79
Services billed 84 a service is one billed item, such as a visit, a test or a procedure
Average patient age74

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

  • Stoughton Hospital Hospital · Stoughton, WI · listed as Stoughton Hospital Association

Colleagues at Stoughton Hospital Association

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 66 clinicians in the practice; 12 are shown here.

Other providers in Madison