Dr Henry Vondell Clark, MD in Tacoma, WA - Medicare Family Medicine

Dr Henry Vondell Clark, MD is a medicare enrolled "Family Medicine" physician in Tacoma, Washington. His current practice location is 9040 Jackson Ave, Tacoma, Washington. You can reach out to his office (for appointments etc.) via phone at (253) 968-2252.

Dr Henry Vondell Clark is licensed to practice in North Carolina (license number 9800216) 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 1790898450.

Contact Information

	Dr Henry Vondell Clark, MD
	9040 Jackson Ave, Tacoma, WA 98431-9361
	(253) 968-2252
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Henry Vondell Clark
Gender	Male
Speciality	Family Medicine
Location	9040 Jackson Ave, Tacoma, Washington
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1790898450
Provider Enumeration Date: 08/16/2006
Last Update Date: 03/07/2023

Medicare PECOS Information:

PECOS PAC ID: 6901961267
Enrollment ID: I20090219000670

Medical Identifiers

Medical identifiers for Dr Henry Vondell Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1790898450	NPI	-	NPPES
11521	Other	NC	BCBS PROVIDER NUMBER
1790898450	Medicaid	NC
9800216	Other	NC	LICENSE - NC

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	9800216 (North Carolina)	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. Dr Henry Vondell Clark allows following entities to bill medicare on his behalf.

Entity Name	Novant Health Medical Group, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1366409492 PECOS PAC ID: 1153234893 Enrollment ID: O20031121000692

Entity Name	Novant Health Medical Group, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1306950282 PECOS PAC ID: 1153234893 Enrollment ID: O20040204001028

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 Henry Vondell 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 Henry Vondell Clark, MD Madigan Army Medical Center, 9040 Jackson Ave., Tacoma, WA 98431 Ph: (253) 968-2252	Dr Henry Vondell Clark, MD 9040 Jackson Ave, Tacoma, WA 98431-9361 Ph: (253) 968-2252

Reviews and Comments

Family Medicine Doctors in Tacoma, WA

Dr. Kristina Siu Petsas, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 209 Martin Luther King Jr Way, Tacoma, WA 98405 Phone: 253-596-3300
Mrs. Anne Garces Laporte, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 209 Martin Luther King Jr Way, Tacoma, WA 98405 Phone: 253-596-3300
James M Roos, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 315 Martin Luther King Jr Way, Tacoma, WA 98405 Phone: 253-403-1000
Dr. Myra Haq, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2209 E 32nd St, Tacoma, WA 98404 Phone: 253-441-2634
Loren B Betteridge, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3733 S Thompson Ave, Tacoma, WA 98418 Phone: 253-472-4473 Fax: 253-474-3056
Dr. Thuy-tien V Le, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 732 Broadway Ste 201, Tacoma, WA 98402 Phone: 702-871-8535 Fax: 941-499-0035
Alexander K Lee, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 315 Martin Luther King Jr Way, Tacoma, WA 98405 Phone: 253-459-7785

Dr Henry Vondell Clark, MD - Medicare Family Medicine in Tacoma, WA