Nathaniel Clark, PA - Medicare Physician Assistant in Carbondale, IL

  1. Home
Nathaniel Clark, PA is a medicare enrolled "Physician Assistant" physician in Carbondale, Illinois. He graduated from medical school in 2008 and has 18 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Deaconess Illinois Specialty Clinic, Inc. and his current practice location is 409 W Oak St, Carbondale, Illinois. You can reach out to his office (for appointments etc.) via phone at (618) 529-4455.

Nathaniel Clark is licensed to practice in Illinois (license number 085003278) 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 1063660074.

Contact Information

Nathaniel Clark, PA
409 W Oak St,
Carbondale, IL 62901-1464
(618) 529-4455
(618) 351-1287

Map and Direction




Physician's Profile

Full NameNathaniel Clark
GenderMale
SpecialityPhysician Assistant
Experience18 Years
Location409 W Oak St, Carbondale, Illinois
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Nathaniel Clark graduated from medical school in 2008
  NPI Data:
  • NPI Number: 1063660074
  • Provider Enumeration Date: 09/03/2008
  • Last Update Date: 12/21/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 7315015948
  • Enrollment ID: I20081008000708

Medical Identifiers

Medical identifiers for Nathaniel Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1063660074NPI-NPPES
P00657126OtherILRAILROAD MEDICARE

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207RI0011XInternal Medicine - Interventional Cardiology 085-003278 (Illinois)Secondary
363A00000XPhysician Assistant 085003278 (Illinois)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Deaconess Illinois Medical CenterMarion, ILHospital
Herrin HospitalHerrin, ILHospital
Ferrell Hospital Community FoundationsEldorado, ILHospital
Northwestern Medicine Central Dupage HospitalWinfield, ILHospital
Memorial Hospital Of CarbondaleCarbondale, ILHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Deaconess Illinois Specialty Clinic, Inc.9830562016145

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. Nathaniel Clark allows following entities to bill medicare on his behalf.
Entity NamePrairie Cardiovascular Consultants Ltd
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1982714218
PECOS PAC ID: 3173435880
Enrollment ID: O20031103000090
Entity NameSouthern Illinois Medical Services Nfp
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1770656837
PECOS PAC ID: 3678677390
Enrollment ID: O20070404000595
Entity NameDeaconess Illinois Specialty Clinic, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1972210235
PECOS PAC ID: 9830562016
Enrollment ID: O20230321001688

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. Nathaniel 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 AddressPractice Location Address
Nathaniel Clark, PA
409 W Oak St,
Carbondale, IL 62901-1464

Ph: (618) 529-4555		Nathaniel Clark, PA
409 W Oak St,
Carbondale, IL 62901-1464

Ph: (618) 529-4455

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.