Dr Clarence E Clark, MD is a medicare enrolled "Colon & Rectal Surgery" physician in Chandler, Arizona. He went to Pennsylvania State University College Of Medicine and graduated in 2004 and has 20 years of diverse experience with area of expertise as Colorectal Surgery (proctology). He is a member of the group practice Sjhmc Physician Services and his current practice location is
1955 W Frye Rd, Chandler, Arizona. You can reach out to his office (for appointments etc.) via phone at
(480) 728-3000.
Dr Clarence E Clark is licensed to practice in Arizona (license number 61606) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1952582397.
Physician's Profile
| Full Name | Dr Clarence E Clark |
|---|
| Gender | Male |
|---|
| Speciality | Colorectal Surgery (proctology) |
|---|
| Experience | 20 Years |
|---|
| Location | 1955 W Frye Rd, Chandler, Arizona |
|---|
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
|---|
Medical Education and Training:
- Dr Clarence E Clark attended and graduated from Pennsylvania State University College Of Medicine in 2004
NPI Data:
- NPI Number: 1952582397
- Provider Enumeration Date: 11/14/2007
- Last Update Date: 03/31/2021
Medicare PECOS Information:
- PECOS PAC ID: 3274725973
- Enrollment ID: I20200904000835
Medical Identifiers
Medical identifiers for Dr Clarence E Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1952582397 | NPI | - | NPPES |
| 003126879C | Medicaid | GA | |
| 003126879A | Medicaid | GA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208600000X | Surgery | 068132 (Georgia) | Secondary |
| 208C00000X | Colon & Rectal Surgery | N2443 (Texas) | Secondary |
| 208C00000X | Colon & Rectal Surgery | 61606 (Arizona) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Sjhmc Physician Services | 4486646197 | 533 |
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 Clarence E Clark allows following entities to bill medicare on his behalf.
| Entity Name | Sjhmc Physician Services |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1326098005
PECOS PAC ID: 4486646197
Enrollment ID: O20040401001189 |
|---|
| Entity Name | St. Joseph's Hospital And Medical Center C/o Dignity Health |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1255382412
PECOS PAC ID: 6709863178
Enrollment ID: O20040702000601 |
|---|
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 Clarence E 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 |
|---|
Dr Clarence E Clark, MD
Po Box 33269,
Phoenix, AZ 85067-3269
Ph: (602) 406-4786 | Dr Clarence E Clark, MD
1955 W Frye Rd,
Chandler, AZ 85224-6282
Ph: (480) 728-3000 |
Reviews and Comments