Dr Derek Alan Clemmer, DMD is a medicare enrolled "Dentist" provider in Ashland, Mississippi. His current practice location is
15921 Boundary Dr, Ashland, Mississippi. You can reach out to his office (for appointments etc.) via phone at
(662) 224-8951.
Dr Derek Alan Clemmer is licensed to practice in Mississippi (license number 3565-10) and he also participates in the medicare program. He
may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1023322765.
Healthcare Provider's Profile
| Full Name | Dr Derek Alan Clemmer |
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| Gender | Male |
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| Speciality | Dentist |
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| Location | 15921 Boundary Dr, Ashland, Mississippi |
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| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Derek Alan Clemmer graduated from medical school in
NPI Data:
- NPI Number: 1023322765
- Provider Enumeration Date: 08/05/2010
- Last Update Date: 08/05/2010
Medicare PECOS Information:
- PECOS PAC ID: 1658840665
- Enrollment ID: I20260519004492
Medical Identifiers
Medical identifiers for Dr Derek Alan Clemmer such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1023322765 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 122300000X | Dentist | 3565-10 (Mississippi) | 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. Dr Derek Alan Clemmer allows following entities to bill medicare on his behalf.
| Entity Name | Boa Vida Hospital of Aberdeen MS LLC |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1710405741
PECOS PAC ID: 0244505840
Enrollment ID: O20171128003460 |
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| Entity Name | Boa Vida Hospital of Aberdeen MS LLC |
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| Entity Type | Part A Provider - Critical Access Hospital |
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| Entity Identifiers | NPI Number: 1285164046
PECOS PAC ID: 0244505840
Enrollment ID: O20171220002880 |
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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. Dr Derek Alan Clemmer 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 |
|---|
Dr Derek Alan Clemmer, DMD
Po Box 92,
Ashland, MS 38603-0092
Ph: (662) 224-8951 | Dr Derek Alan Clemmer, DMD
15921 Boundary Dr,
Ashland, MS 38603-7740
Ph: (662) 224-8951 |
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