Susan Clark, is a medicare enrolled "Case Manager/care Coordinator" provider in Stillwater, Oklahoma. Her current practice location is
604 S Walnut, Stillwater, Oklahoma. You can reach out to her office (for appointments etc.) via phone at
(405) 372-2202.
Susan Clark is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1528591575.
Healthcare Provider's Profile
Full Name | Susan Clark |
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Gender | Female |
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Speciality | Case Manager/care Coordinator |
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Location | 604 S Walnut, Stillwater, Oklahoma |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1528591575
- Provider Enumeration Date: 04/06/2017
- Last Update Date: 08/13/2019
Medicare PECOS Information:
- PECOS PAC ID: 7012439722
- Enrollment ID: I20250321001849
Medical Identifiers
Medical identifiers for Susan Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1528591575 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101Y00000X | Counselor | (* (Not Available)) | Secondary |
171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Primary |
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. Susan Clark allows following entities to bill medicare on her behalf.
Entity Name | Grand Lake Mental Health Center, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1497762520 PECOS PAC ID: 4688711534 Enrollment ID: O20091026000174 |
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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. Susan 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 |
Susan Clark, 604 S Walnut, Stillwater, OK 74074-4222 Ph: (405) 372-2202 | Susan Clark, 604 S Walnut, Stillwater, OK 74074-4222 Ph: (405) 372-2202 |
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