Jennifer Diane Clark, MD in Midlothian, VA

Jennifer Diane Clark, MD is a medicare enrolled "Pediatrics" physician in Midlothian, Virginia. Her current practice location is 14732 Village Square Pl, Midlothian, Virginia. You can reach out to her office (for appointments etc.) via phone at (804) 639-0717.

Jennifer Diane Clark is licensed to practice in Maine (license number MD23961) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1871556878.

Contact Information

	Jennifer Diane Clark, MD
	14732 Village Square Pl, Midlothian, VA 23112-2253
	(804) 639-0717
	(804) 639-0767

Map and Direction

Physician's Profile

Full Name	Jennifer Diane Clark
Gender	Female
Speciality	Pediatrics
Location	14732 Village Square Pl, Midlothian, Virginia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1871556878
Provider Enumeration Date: 04/10/2006
Last Update Date: 01/28/2021

Medicare PECOS Information:

PECOS PAC ID: 5799196952
Enrollment ID: I20201119003123

Medical Identifiers

Medical identifiers for Jennifer Diane Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1871556878	NPI	-	NPPES
432058755	Other	VA	TRICARE
1382954	Other	VA	FIRST HEALTH NETWORK
010121086	Medicaid	VA
10007264	Other	VA	OPTIMA HEALTH
1240927	Other	VA	UNITED HEALTH CARE
171941	Other	VA	ANTHEM BCBS
5056305	Other	VA	FHN PRODUCT, CCN
299592	Other	VA	SOUTHERN HEALTH
5214032	Other	VA	AETNA PPO
432058755	Other	VA	GREAT WEST
3649627	Other	VA	AETNA HMO
4768718	Other	VA	CIGNA
432058755	Other	VA	PHCS

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	0101 056329 (Virginia)	Secondary
208000000X	Pediatrics	MD23961 (Maine)	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. Jennifer Diane Clark allows following entities to bill medicare on her behalf.

Entity Name	Mrh Corp
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1558319103 PECOS PAC ID: 1355770892 Enrollment ID: O20200803002384

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. Jennifer Diane 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
Jennifer Diane Clark, MD 14732 Village Square Pl, Midlothian, VA 23112-2253 Ph: (804) 639-0717	Jennifer Diane Clark, MD 14732 Village Square Pl, Midlothian, VA 23112-2253 Ph: (804) 639-0717

Reviews and Comments

Pediatrics Doctors in Midlothian, VA

Dr. Joel C Everett, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 13821 Village Mill Dr, Midlothian, VA 23114 Phone: 804-794-2821 Fax: 804-794-4072
Arpita Gupta Depalma, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 11601 Robious Rd, Suite 100, Midlothian, VA 23113 Phone: 804-379-9494
Dr. Linda A Burk, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 16213 Saville Chase Ln, Midlothian, VA 23112 Phone: 804-432-8817
Dr. Gordon Neil Kellett Ii, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 13821 Village Mill Dr, Midlothian, VA 23114 Phone: 804-794-2821 Fax: 804-794-4072
Dr. Mark A Flanzenbaum, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5021 Craig Rath Blvd Bldg 4, Midlothian, VA 23112 Phone: 804-592-5437 Fax: 804-474-9071
Dr. Elizabeth Marie Cullen, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1407 Huguenot Rd, Midlothian, VA 23113 Phone: 804-794-2299 Fax: 804-794-5774
Isca Rochelle Wilms, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 13700 St Francis Blvd, Suite 501, Midlothian, VA 23114 Phone: 804-378-4420 Fax: 804-378-4440

Jennifer Diane Clark, MD - Medicare Pediatrics in Midlothian, VA