John Clarke, is a medicare enrolled "Anesthesiology" physician in Clearlake, California. His current practice location is
15630 18th Ave, Clearlake, California. You can reach out to his office (for appointments etc.) via phone at
(707) 994-6486.
John Clarke is licensed to practice in California (license number NA1636) 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 1053329359.
Physician's Profile
| Full Name | John Clarke |
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| Gender | Male |
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| Speciality | Anesthesiology |
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| Location | 15630 18th Ave, Clearlake, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1053329359
- Provider Enumeration Date: 08/03/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 5890782619
- Enrollment ID: I20040707000687
Medical Identifiers
Medical identifiers for John Clarke such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1053329359 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207L00000X | Anesthesiology | NA1636 (California) | 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. John Clarke allows following entities to bill medicare on his behalf.
| Entity Name | Lyons Huber Management |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1891370854
PECOS PAC ID: 4789093741
Enrollment ID: O20210504002949 |
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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. John Clarke 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 |
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John Clarke,
1750 Westlake Dr,
Kelseyville, CA 95451-7049
Ph: (707) 994-6486 | John Clarke,
15630 18th Ave,
Clearlake, CA 95422
Ph: (707) 994-6486 |
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