Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Nathaniel Clark, PA

Individual provider Interventional Cardiology Physician · NPI 1063660074

Nathaniel Clark, PA is a Physician Assistant in Carbondale, Illinois. Qualified in 2008, 18 years ago. Practices with Deaconess Illinois Specialty Clinic, Inc, a 139-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
18
Licensed in
IL
In the registry since
2008
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

409 W Oak St
Carbondale, IL 62901-1464
Phone: (618) 529-4455
Fax: (618) 351-1287
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 100 Dr Warren Tuttle Dr, Harrisburg, IL 62946-2718 — (618) 529-4455
  • 217 S Park Ave Ste 2, Herrin, IL 62948-3611 — (618) 529-4455
  • 3905 W Ernestine Dr, Marion, IL 62959-5800 — (618) 529-4455

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085003278 (IL)
Interventional Cardiology Physician Taxonomy 207RI0011X · Licence 085-003278 (IL)

Record details

NPI number1063660074
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 3, 2008
Last updated in NPPESDecember 21, 2022
Certification dateDecember 21, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Deaconess Illinois Specialty Clinic, Inc. — 139 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 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 patients710
Services billed 1,818 a service is one billed item, such as a visit, a test or a procedure
Average patient age75

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.

Payments from drug and device companies, 2025

Drug and device makers are required by federal law (the Physician Payments Sunshine Act) to report what they pay or give to clinicians, and CMS publishes the reports as Open Payments. This is the 2025 program year. A report is a record of a payment, not an allegation of anything, and many are small items such as meals. Only general payments are listed here; research payments and ownership or investment interests are reported separately by CMS and are not shown.

Food and Beverage $1,413 71 payments · a meal or drink at a meeting or visit, not a fee

Each amount is the sum of what companies reported for that kind of payment in 2025, rounded to the dollar. Not all of it is income to the clinician: a meal is not a fee, a charitable contribution goes to a charity, and a royalty or an acquisition payment is not a salary.

Check a report, or dispute one, at the source in CMS’s own tool, Open Payments. Corrections go through CMS’s dispute process. This site removes a home address on request and asks for no proof, because that is privacy; it will not remove an accurate payment report on request, because that is a statutory public disclosure.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician. Those with a page here are linked.

Colleagues at Deaconess Illinois Specialty Clinic, Inc

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 139 clinicians in the practice; 12 are shown here.

Other providers in Carbondale