Dr Stephanie Donoso Clark, MD is a medicare enrolled "Preventive Medicine - Undersea And Hyperbaric Medicine" physician in Leesburg, Florida. She graduated from medical school in 2019 and has 7 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Yuma Regional Medical Center, Curelogics Wound Care And Hyperbaric Llc and her current practice location is
1414 E Main St Ste 2, Leesburg, Florida. You can reach out to her office (for appointments etc.) via phone at
(352) 775-2055.
Dr Stephanie Donoso Clark is licensed to practice in Florida (license number ME165643) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1487276614.
Physician's Profile
| Full Name | Dr Stephanie Donoso Clark |
|---|
| Gender | Female |
|---|
| Speciality | Family Practice |
|---|
| Experience | 7 Years |
|---|
| Location | 1414 E Main St Ste 2, Leesburg, Florida |
|---|
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
|---|
Medical Education and Training:
- Dr Stephanie Donoso Clark graduated from medical school in 2019
NPI Data:
- NPI Number: 1487276614
- Provider Enumeration Date: 05/11/2020
- Last Update Date: 02/24/2026
Medicare PECOS Information:
- PECOS PAC ID: 7810310695
- Enrollment ID: I20231013001020
Medical Identifiers
Medical identifiers for Dr Stephanie Donoso Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1487276614 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | ME165643 (Florida) | Secondary |
| 2083P0011X | Preventive Medicine - Undersea And Hyperbaric Medicine | ME165643 (Florida) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Yuma Regional Medical Center | 2062314826 | 359 |
| Curelogics Wound Care And Hyperbaric Llc | 8820335854 | 3 |
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 Stephanie Donoso Clark allows following entities to bill medicare on her behalf.
| Entity Name | Yuma Regional Medical Center |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1194706655
PECOS PAC ID: 2062314826
Enrollment ID: O20040122000526 |
|---|
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 Stephanie Donoso 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 Stephanie Donoso Clark, MD
1414 E Main St Ste 2,
Leesburg, FL 34748-5399
Ph: (352) 775-2055 | Dr Stephanie Donoso Clark, MD
1414 E Main St Ste 2,
Leesburg, FL 34748-5399
Ph: (352) 775-2055 |
Reviews and Comments