Benjamin Jacob Clark, CRNA in Elkhart, IN - Medicare Certified Registered Nurse Anesthetist (crna)

Benjamin Jacob Clark, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Elkhart, Indiana. He went to Albany Medical College Of Union University and graduated in 2010 and has 14 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Premier Anesthesia Of Richland A Division Of Premier Anesthesia, Llc and his current practice location is 600 East Blvd, Elkhart, Indiana. You can reach out to his office (for appointments etc.) via phone at (574) 523-3193.

Benjamin Jacob Clark is licensed to practice in Indiana (license number 28193318A) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1407150055.

Contact Information

	Benjamin Jacob Clark, CRNA
	600 East Blvd, Elkhart, IN 46514-2483
	(574) 523-3193
	Not Available

Map and Direction

Provider's Profile

Full Name	Benjamin Jacob Clark
Gender	Male
Speciality	Certified Registered Nurse Anesthetist (crna)
Experience	14 Years
Location	600 East Blvd, Elkhart, Indiana
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Benjamin Jacob Clark attended and graduated from Albany Medical College Of Union University in 2010

NPI Data:

NPI Number: 1407150055
Provider Enumeration Date: 12/22/2010
Last Update Date: 12/22/2010

Medicare PECOS Information:

PECOS PAC ID: 4688858285
Enrollment ID: I20181217002203

Medical Identifiers

Medical identifiers for Benjamin Jacob Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1407150055	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	28193318A (Indiana)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Kadlec Regional Medical Center	Richland, WA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Premier Anesthesia Of Richland A Division Of Premier Anesthesia, Llc	4880699172	56

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Benjamin Jacob Clark allows following entities to bill medicare on his behalf.

Entity Name	Premier Anesthesia Of Richland A Division Of Premier Anesthesia, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1013940253 PECOS PAC ID: 4880699172 Enrollment ID: O20060920000047

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Benjamin Jacob Clark is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Benjamin Jacob Clark, CRNA 14660 Carrigan Ct, Granger, IN 46530-4222 Ph: (574) 523-3193	Benjamin Jacob Clark, CRNA 600 East Blvd, Elkhart, IN 46514-2483 Ph: (574) 523-3193

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Elkhart, IN

Mr. Taqi Qays Abdu-as-salaam, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 500 N Nappanee St, Suite 11, Elkhart, IN 46514 Phone: 574-522-9922
Mark Mcpherson, RN Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 600 East Blvd, Elkhart, IN 46514 Phone: 574-523-3193
Ms. Barbara Ann Doherty, C.R.N.A. Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1004 Parkway Ave, Suite B, Elkhart, IN 46516 Phone: 574-522-9922 Fax: 574-522-9926
Naznin Lalani, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 500 N Nappanee, Ste 11b, Elkhart, IN 46514 Phone: 574-522-9922
Joshua Stewart, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 600 East Blvd, Elkhart, IN 46514 Phone: 574-294-2621
Lindsay Vasil, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1513 E Jackson Blvd, Elkhart, IN 46516 Phone: 574-523-3193
Denise Christine Brown, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 600 East Blvd, Elkhart, IN 46514 Phone: 574-523-3193 Fax: 574-523-3463

Benjamin Jacob Clark, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Elkhart, IN