Dr Samuel J Clark, MD - Medicare Pulmonary Disease in San Diego, CA

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Dr Samuel J Clark, MD is a medicare enrolled "Internal Medicine - Pulmonary Disease" physician in San Diego, California. He went to Vanderbilt University School Of Medicine and graduated in 1992 and has 32 years of diverse experience with area of expertise as Pulmonary Disease. He is a member of the group practice Samuel J Clark Md Inc, Sd Diagnostics Inc, Chest Medicine And Critical Care Medical Group Inc, Emergency And Acute Care Medical Corporation and his current practice location is 1940 El Cajon Blvd, San Diego, California. You can reach out to his office (for appointments etc.) via phone at (619) 543-4500.

Dr Samuel J Clark is licensed to practice in California (license number A52335) 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 1689611709.

Contact Information

Dr Samuel J Clark, MD
1940 El Cajon Blvd,
San Diego, CA 92104-1005
(619) 543-4500
(619) 295-5600

Map and Direction




Physician's Profile

Full NameDr Samuel J Clark
GenderMale
SpecialityPulmonary Disease
Experience32 Years
Location1940 El Cajon Blvd, San Diego, California
Accepts Medicare AssignmentsYes. 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 Samuel J Clark attended and graduated from Vanderbilt University School Of Medicine in 1992
  NPI Data:
  • NPI Number: 1689611709
  • Provider Enumeration Date: 05/31/2006
  • Last Update Date: 04/08/2015
  Medicare PECOS Information:
  • PECOS PAC ID: 5991777054
  • Enrollment ID: I20060420000454

Medical Identifiers

Medical identifiers for Dr Samuel J Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1689611709NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207RP1001XInternal Medicine - Pulmonary Disease A52335 (California)Primary
207R00000XInternal Medicine A52335 (California)Secondary
207RC0200XInternal Medicine - Critical Care Medicine A52335 (California)Secondary
207RS0012XInternal Medicine - Sleep Medicine A52335 (California)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Sharp Memorial HospitalSan diego, CAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Samuel J Clark Md Inc05472794992
Sd Diagnostics Inc38707239508
Chest Medicine And Critical Care Medical Group Inc610389825926
Emergency And Acute Care Medical Corporation9537108279382

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 Samuel J Clark allows following entities to bill medicare on his behalf.
Entity NameChest Medicine And Critical Care Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1841292521
PECOS PAC ID: 6103898259
Enrollment ID: O20040809001379
Entity NameEmergency And Acute Care Medical Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1437103942
PECOS PAC ID: 9537108279
Enrollment ID: O20050502000734
Entity NameSamuel J Clark Md Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1124079793
PECOS PAC ID: 0547279499
Enrollment ID: O20060420000417
Entity NameKnd Development 59 Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1740519081
PECOS PAC ID: 3678602802
Enrollment ID: O20100724000249
Entity NameSd Diagnostics Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1003252834
PECOS PAC ID: 3870723950
Enrollment ID: O20140312001772

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 Samuel J 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
Dr Samuel J Clark, MD
1940 El Cajon Blvd,
San Diego, CA 92104-1005

Ph: (619) 543-4500		Dr Samuel J Clark, MD
1940 El Cajon Blvd,
San Diego, CA 92104-1005

Ph: (619) 543-4500

Reviews and Comments


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