Susan B Clark, MS, RD, LD, CDE - Medicare Dietitian in Rexburg, ID

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Susan B Clark, MS, RD, LD, CDE is a medicare enrolled "Dietitian, Registered" provider in Rexburg, Idaho. Her current practice location is 393 E 2nd N, Rexburg, Idaho. You can reach out to her office (for appointments etc.) via phone at (208) 356-5401.

Susan B Clark is licensed to practice in Idaho (license number D-393) 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 1124676663.

Contact Information

Susan B Clark, MS, RD, LD, CDE
393 E 2nd N,
Rexburg, ID 83440-1605
(208) 356-5401
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameSusan B Clark
GenderFemale
SpecialityDietitian, Registered
Location393 E 2nd N, Rexburg, Idaho
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1124676663
  • Provider Enumeration Date: 08/28/2019
  • Last Update Date: 11/24/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 3476980053
  • Enrollment ID: I20200318001657

Medical Identifiers

Medical identifiers for Susan B Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1124676663NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
133V00000XDietitian, Registered D-393 (Idaho)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 B Clark allows following entities to bill medicare on her behalf.
Provider NameMadison Co Memorial Hospital
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1134592017
PECOS PAC ID: 8123016367
Enrollment ID: O20040505000664

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 B 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 AddressPractice Location Address
Susan B Clark, MS, RD, LD, CDE
450 E Main St,
Rexburg, ID 83440-2048

Ph: (208) 359-6522		Susan B Clark, MS, RD, LD, CDE
393 E 2nd N,
Rexburg, ID 83440-1605

Ph: (208) 356-5401

Reviews and Comments


Dietitian, Registered in Rexburg, ID

Mrs. Wendy Marie Killian, RD LD
Dietitian
Medicare: Not Enrolled in Medicare
Practice Location: 393 E 2nd N, Rexburg, ID 83440
Phone: 208-356-5401    
Dennis V Nguyen, RD
Dietitian
Medicare: Not Enrolled in Medicare
Practice Location: 7312 S 400 W, Rexburg, ID 83440
Phone: 208-690-0357    
Avarie Olsen, RDN
Dietitian
Medicare: Not Enrolled in Medicare
Practice Location: 793 S 2275 W, Rexburg, ID 83440
Phone: 208-201-3892    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.