Clarke Latta Henry Jr, MD is a medicare enrolled "Thoracic Surgery (cardiothoracic Vascular Surgery)" physician in Shawnee Mission, Kansas. His current practice location is
8901 W 74th St, Suite 1, Shawnee Mission, Kansas. You can reach out to his office (for appointments etc.) via phone at
(913) 341-0120.
Clarke Latta Henry Jr is licensed to practice in Missouri (license number R7F67) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1750389029.
Physician's Profile
| Full Name | Clarke Latta Henry Jr |
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| Gender | Male |
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| Speciality | Thoracic Surgery (cardiothoracic Vascular Surgery) |
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| Location | 8901 W 74th St, Shawnee Mission, Kansas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1750389029
- Provider Enumeration Date: 07/12/2005
- Last Update Date: 02/25/2011
Medicare PECOS Information:
- PECOS PAC ID: 9638226301
- Enrollment ID: I20090415000358
Medical Identifiers
Medical identifiers for Clarke Latta Henry Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1750389029 | NPI | - | NPPES |
| 202277919 | Medicaid | MO | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | R7F67 (Missouri) | 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. Clarke Latta Henry Jr allows following entities to bill medicare on his behalf.
| Entity Name | Shawnee Mission Medical Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1992735690
PECOS PAC ID: 9537119037
Enrollment ID: O20050701000310 |
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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. Clarke Latta Henry Jr 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 |
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Clarke Latta Henry Jr, MD
8901 W 74th Street, Suite 1,
Shawnee Mission, KS 66204-2201
Ph: (913) 341-0120 | Clarke Latta Henry Jr, MD
8901 W 74th St, Suite 1,
Shawnee Mission, KS 66204-2204
Ph: (913) 341-0120 |
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