Jack O Clark, MD in Rexburg, ID - Medicare Internal Medicine

Jack O Clark, MD is a medicare enrolled "Internal Medicine" physician in Rexburg, Idaho. He went to Pennsylvania State University College Of Medicine and graduated in 1999 and has 25 years of diverse experience with area of expertise as Internal Medicine. He is a member of the group practice Madison Memorial Hospital, Madison Co Memorial Hospital and his current practice location is 450 E Main St, Rexburg, Idaho. You can reach out to his office (for appointments etc.) via phone at (208) 359-6419.

Jack O Clark is licensed to practice in Idaho (license number M-7743) 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 1902992837.

Contact Information

	Jack O Clark, MD
	450 E Main St, Rexburg, ID 83440
	(208) 359-6419
	(208) 356-3111

Map and Direction

Physician's Profile

Full Name	Jack O Clark
Gender	Male
Speciality	Internal Medicine
Experience	25 Years
Location	450 E Main St, Rexburg, Idaho
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:

Jack O Clark attended and graduated from Pennsylvania State University College Of Medicine in 1999

NPI Data:

NPI Number: 1902992837
Provider Enumeration Date: 10/05/2006
Last Update Date: 04/13/2020

Medicare PECOS Information:

PECOS PAC ID: 2264564491
Enrollment ID: I20100722000929

Medical Identifiers

Medical identifiers for Jack O Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1902992837	NPI	-	NPPES
10018055	Other	ID	REGENCE BCBS IDAHO
114780300	Medicaid	WY
80633500	Medicaid	ID
58289	Other	ID	BLUE CROSS IDAHO
805499200	Medicaid	ID

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	M-7743 (Idaho)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Madison Memorial Hospital	Rexburg, ID	Hospital
Madison Carriage Cove Short Stay Rehabilitation	Rexburg, ID	Nursing home

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Madison Memorial Hospital	4183949522	14
Madison Co Memorial Hospital	8123016367	25

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. Jack O Clark allows following entities to bill medicare on his behalf.

Entity Name	Madison Co Memorial Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1134592017 PECOS PAC ID: 8123016367 Enrollment ID: O20040505000664

Entity Name	Madison Memorial Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1346643038 PECOS PAC ID: 4183949522 Enrollment ID: O20150206000933

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. Jack O 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
Jack O Clark, MD 450 E Main St, Rexburg, ID 83440-2048 Ph: (208) 359-6419	Jack O Clark, MD 450 E Main St, Rexburg, ID 83440 Ph: (208) 359-6419

Reviews and Comments

Internal Medicine Doctors in Rexburg, ID

Dr. Steven Hansen Lofgran, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 37 S 2nd E, Rexburg, ID 83440 Phone: 208-356-0234 Fax: 208-656-8444
Mr. Craig D Heiner, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 240 East Main, Rexburg, ID 83440 Phone: 208-356-8808 Fax: 208-356-8810
Dr. Hans Thurgood Redd, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 100 Shc, Rexburg, ID 83460 Phone: 208-496-1300 Fax: 208-496-1306
Dr. Dane J Dickson, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 380 Walker Drive, Rexburg, ID 83440 Phone: 208-356-9559 Fax: 208-356-6601
Rodney Bates Jr., DO Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 36 Professional Plz, Rexburg, ID 83440 Phone: 208-359-9411 Fax: 208-656-8444

Jack O Clark, MD - Medicare Internal Medicine in Rexburg, ID