Shane B Clark, DO in Fleming Island, FL - Medicare Hematology/oncology

Shane B Clark, DO is a medicare enrolled "Internal Medicine - Hematology & Oncology" physician in Fleming Island, Florida. He graduated from medical school in 2018 and has 7 years of diverse experience with area of expertise as Hematology/oncology. He is a member of the group practice Baptist Md Anderson Cancer Physicians Inc and his current practice location is 2310 Village Square Pkwy Ste 106c, Fleming Island, Florida. You can reach out to his office (for appointments etc.) via phone at (904) 202-7300.

Shane B Clark is licensed to practice in Florida (license number OS21375) 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 1902391477.

Contact Information

	Shane B Clark, DO
	2310 Village Square Pkwy Ste 106c, Fleming Island, FL 32003-6409
	(904) 202-7300
	(904) 202-2754

Map and Direction

Physician's Profile

Full Name	Shane B Clark
Gender	Male
Speciality	Hematology/oncology
Experience	7 Years
Location	2310 Village Square Pkwy Ste 106c, Fleming Island, Florida
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:

Shane B Clark graduated from medical school in 2018

NPI Data:

NPI Number: 1902391477
Provider Enumeration Date: 06/27/2018
Last Update Date: 04/30/2025

Medicare PECOS Information:

PECOS PAC ID: 1153679394
Enrollment ID: I20240903001293

Medical Identifiers

Medical identifiers for Shane B Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1902391477	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207RH0000X	Internal Medicine - Hematology	OS21375 (Florida)	Secondary
207RX0202X	Internal Medicine - Medical Oncology	OS21375 (Florida)	Secondary
207RH0003X	Internal Medicine - Hematology & Oncology	OS21375 (Florida)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Baptist Health Medical Center - Jacksonville	Jacksonville, FL	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Baptist Md Anderson Cancer Physicians Inc	5991932063	107

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. Shane B Clark allows following entities to bill medicare on his behalf.

Entity Name	Baptist Md Anderson Cancer Physicians Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1538593124 PECOS PAC ID: 5991932063 Enrollment ID: O20131217000276

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. Shane B 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
Shane B Clark, DO Po Box 746654, Atlanta, GA 30374-6654 Ph: (904) 202-2092	Shane B Clark, DO 2310 Village Square Pkwy Ste 106c, Fleming Island, FL 32003-6409 Ph: (904) 202-7300

Reviews and Comments

Internal Medicine Doctors in Fleming Island, FL

Augusto E Villegas, MD Hematology & Oncology Medicare: Accepting Medicare Assignments Practice Location: 4689 Us Highway 17 Ste 2-5, Fleming Island, FL 32003 Phone: 904-269-6526 Fax: 904-269-6527
Dr. Hema Madhavi Vankayala, MD Hematology & Oncology Medicare: Accepting Medicare Assignments Practice Location: 2370 Market Dr, Fleming Island, FL 32003 Phone: 904-264-6201 Fax: 904-264-6858
Carlos Rafael Zamora, M.D. Hematology & Oncology Medicare: Accepting Medicare Assignments Practice Location: 1747 Baptist Clay Dr, Suite 320, Fleming Island, FL 32003 Phone: 904-224-5185 Fax: 904-278-7284
Dr. Mehdi M Moezi, MD Hematology & Oncology Medicare: Accepting Medicare Assignments Practice Location: 2370 Market Dr, Fleming Island, FL 32003 Phone: 094-264-6201 Fax: 904-264-6858
Dr. Kabir A Yousuf, MD Hematology & Oncology Medicare: Accepting Medicare Assignments Practice Location: 1747 Baptist Clay Dr Ste 320, Fleming Island, FL 32003 Phone: 904-224-5185 Fax: 904-278-7284
Spencer Chapman Knox, M.D. Hematology & Oncology Medicare: Accepting Medicare Assignments Practice Location: 1747 Baptist Clay Dr Ste 300, Fleming Island, FL 32003 Phone: 904-214-8080 Fax: 904-214-8081
Dr. Sheila Ivette Gonzalez, M.D. Hematology & Oncology Medicare: Accepting Medicare Assignments Practice Location: 5000-18 Us Hwy 17 S #331, Fleming Island, FL 32003 Phone: 904-990-1190 Fax: 904-672-2047

Shane B Clark, DO - Medicare Hematology/oncology in Fleming Island, FL