Chad Jeremy Clark, DO - Medicare Obstetrics/gynecology in Park City, UT

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Chad Jeremy Clark, DO is a medicare enrolled "Obstetrics & Gynecology" physician in Park City, Utah. He graduated from medical school in 2001 and has 25 years of diverse experience with area of expertise as Obstetrics/gynecology. His current practice location is 900 Round Valley Dr, Suite 200, Park City, Utah. You can reach out to his office (for appointments etc.) via phone at (435) 658-7400.

Chad Jeremy Clark is licensed to practice in Utah (license number 8984876-1204) 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 1346339496.

Contact Information

Chad Jeremy Clark, DO
900 Round Valley Dr, Suite 200,
Park City, UT 84060-7552
(435) 658-7400
Not Available

Map and Direction




Physician's Profile

Full NameChad Jeremy Clark
GenderMale
SpecialityObstetrics/gynecology
Experience25 Years
Location900 Round Valley Dr, Park City, Utah
Accepts Medicare AssignmentsMay be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Chad Jeremy Clark graduated from medical school in 2001
  NPI Data:
  • NPI Number: 1346339496
  • Provider Enumeration Date: 10/12/2006
  • Last Update Date: 04/20/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 4284784588
  • Enrollment ID: I20250516000774

Medical Identifiers

Medical identifiers for Chad Jeremy Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1346339496NPI-NPPES
46699OtherCOLICENSE

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 46699 (Colorado)Secondary
207V00000XObstetrics & Gynecology DOS994 (Hawaii)Secondary
207V00000XObstetrics & Gynecology 8984876-1204 (Utah)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. Chad Jeremy Clark allows following entities to bill medicare on his behalf.
Entity NameKauai Medical Clinic
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1376596643
PECOS PAC ID: 5092628479
Enrollment ID: O20031111000540

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. Chad Jeremy 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
Chad Jeremy Clark, DO
Po Box 30180,
Salt Lake City, UT 84130-0180

Ph: (719) 330-7854		Chad Jeremy Clark, DO
900 Round Valley Dr, Suite 200,
Park City, UT 84060-7552

Ph: (435) 658-7400

Reviews and Comments


Obstetrics & Gynecology Doctors in Park City, UT

Dr. Felicia R Katz, M.D.
Obstetrics & Gynecology
Medicare: Accepting Medicare Assignments
Practice Location: 1743 Redstone Center Dr Ste 115, Park City, UT 84098
Phone: 435-658-9200    Fax: 435-658-9210
Dr. William Gary Smith, M.D.
Obstetrics & Gynecology
Medicare: Not Enrolled in Medicare
Practice Location: 2501 Creek Drive, Park City, UT 84060
Phone: 435-649-6662    
Mrs. Robin Lynn Houpe, MD
Obstetrics & Gynecology
Medicare: Accepting Medicare Assignments
Practice Location: 900 Round Valley Dr Ste 200, Park City, UT 84060
Phone: 435-658-7400    
Jeanne M Falk, MD
Obstetrics & Gynecology
Medicare: Accepting Medicare Assignments
Practice Location: 900 Round Valley Dr, Park City, UT 84060
Phone: 435-658-7400    Fax: 435-658-7401
Dr. Tania Patricia Nisimblat Bodnar, M.D.
Obstetrics & Gynecology
Medicare: Medicare Enrolled
Practice Location: 900 Round Valley Dr Ste 200, Park City, UT 84060
Phone: 435-658-7400    

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.