Susan L Clark, MD is a medicare enrolled "Psychiatry & Neurology - Psychiatry" physician in Mukilteo, Washington. Her current practice location is
9515 60th Ave W, Mukilteo, Washington. You can reach out to her office (for appointments etc.) via phone at
(425) 355-2800.
Susan L Clark is licensed to practice in Washington (license number 025209MD00022790) 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 1598892085.
Physician's Profile
| Full Name | Susan L Clark |
|---|
| Gender | Female |
|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
|---|
| Location | 9515 60th Ave W, Mukilteo, Washington |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1598892085
- Provider Enumeration Date: 02/28/2007
- Last Update Date: 12/20/2011
Medicare PECOS Information:
- PECOS PAC ID: 2860589355
- Enrollment ID: I20071031000129
Medical Identifiers
Medical identifiers for Susan L Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1598892085 | NPI | - | NPPES |
| 91202381600 | Other | | UNIFORM |
| 148493100000 | Other | | PREMERA |
| 9120238161816CL | Other | | REGENCE |
| 822269436 | Other | WA | UNITED BEHAVIORAL HEALTH |
| 177558 | Other | WA | VALUEOPTIONS |
| 1117944 | Medicaid | WA | |
| 381601 | Other | | PACIFICARE |
| 389227520070221 | Other | WA | COMMUNITY HEALTH PLAN |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 025209MD00022790 (Washington) | 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. Susan L Clark allows following entities to bill medicare on her behalf.
| Entity Name | Shifa Health Pllc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1356415327
PECOS PAC ID: 9638070501
Enrollment ID: O20040115000310 |
|---|
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. Susan L 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 |
|---|
Susan L Clark, MD
9515 60th Ave W,
Mukilteo, WA 98275
Ph: (425) 355-2800 | Susan L Clark, MD
9515 60th Ave W,
Mukilteo, WA 98275
Ph: (425) 355-2800 |
Reviews and Comments