Dr Michael Jonathan Clark, MD is a medicare enrolled "Otolaryngology" physician in Venice, Florida. He went to University Of Louisville School Of Medicine and graduated in 2005 and has 19 years of diverse experience with area of expertise as Otolaryngology. He is a member of the group practice Island Ent Llc and his current practice location is
420 Nokomis Ave S, Venice, Florida. You can reach out to his office (for appointments etc.) via phone at
(941) 355-2767.
Dr Michael Jonathan Clark is licensed to practice in Pennsylvania (license number MT186642) 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 1619134970.
Physician's Profile
| Full Name | Dr Michael Jonathan Clark |
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| Gender | Male |
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| Speciality | Otolaryngology |
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| Experience | 19 Years |
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| Location | 420 Nokomis Ave S, Venice, Florida |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Michael Jonathan Clark attended and graduated from University Of Louisville School Of Medicine in 2005
NPI Data:
- NPI Number: 1619134970
- Provider Enumeration Date: 05/22/2008
- Last Update Date: 10/28/2021
Medicare PECOS Information:
- PECOS PAC ID: 6608907142
- Enrollment ID: I20191230001910
Medical Identifiers
Medical identifiers for Dr Michael Jonathan Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1619134970 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Y00000X | Otolaryngology | MT186642 (Pennsylvania) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Island Ent Llc | 9638547862 | 2 |
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 Michael Jonathan Clark allows following entities to bill medicare on his behalf.
| Entity Name | Island Ent Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1366165607
PECOS PAC ID: 9638547862
Enrollment ID: O20221121000051 |
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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 Michael Jonathan 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 |
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Dr Michael Jonathan Clark, MD
2401 University Pkwy Ste 102,
Sarasota, FL 34243-2894
Ph: (941) 355-2767 | Dr Michael Jonathan Clark, MD
420 Nokomis Ave S,
Venice, FL 34285-2617
Ph: (941) 355-2767 |
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