Kellie Marie Clark, MD in Middleville, MI

Kellie Marie Clark, MD is a medicare enrolled "Family Medicine" physician in Middleville, Michigan. She graduated from medical school in 2021 and has 4 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Pennock Hospital and her current practice location is 490 Edward St, Middleville, Michigan. You can reach out to her office (for appointments etc.) via phone at (269) 795-4434.

Kellie Marie Clark is licensed to practice in Michigan (license number 4301511876) 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 1619585403.

Contact Information

	Kellie Marie Clark, MD
	490 Edward St, Middleville, MI 49333-9131
	(269) 795-4434
	(269) 795-4271

Map and Direction

Physician's Profile

Full Name	Kellie Marie Clark
Gender	Female
Speciality	Family Practice
Experience	4 Years
Location	490 Edward St, Middleville, Michigan
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:

Kellie Marie Clark graduated from medical school in 2021

NPI Data:

NPI Number: 1619585403
Provider Enumeration Date: 07/17/2020
Last Update Date: 09/11/2024

Medicare PECOS Information:

PECOS PAC ID: 8426459942
Enrollment ID: I20240626000640

Medical Identifiers

Medical identifiers for Kellie Marie Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1619585403	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	4301511876 (Michigan)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Spectrum Health Pennock	Hastings, MI	Hospital
Spectrum Health	Grand rapids, MI	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Pennock Hospital	4587551015	46

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. Kellie Marie Clark allows following entities to bill medicare on her behalf.

Entity Name	Pennock Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1518186295 PECOS PAC ID: 4587551015 Enrollment ID: O20040301000595

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. Kellie Marie 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
Kellie Marie Clark, MD 100 Michigan St Ne # Mc845, Grand Rapids, MI 49503-2560 Ph: () -	Kellie Marie Clark, MD 490 Edward St, Middleville, MI 49333-9131 Ph: (269) 795-4434

Reviews and Comments

Family Medicine Doctors in Middleville, MI

Dr. Lynda Jeanne Margaret Simpson, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 490 Edward St, Middleville, MI 49333 Phone: 269-795-4434
Dr. Christopher James Noah, MD Family Medicine Medicare: May Accept Medicare Assignments Practice Location: 4525 N M 37 Hwy, Ste M, Middleville, MI 49333 Phone: 269-795-4434 Fax: 269-795-4271
Matthew Risk Garber, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 490 Edward St, Middleville, MI 49333 Phone: 269-795-4434

Kellie Marie Clark, MD - Medicare Family Practice in Middleville, MI