Amy Declerk, APRN in Fort Smith, AR - Medicare Nurse Practitioner

Amy Declerk, APRN is a medicare enrolled "Nurse Practitioner - Family" in Fort Smith, Arkansas. She graduated from nursing school in 2014 and has 12 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Ideal Telemedicine Services Llc, Ideal Option Pllc and her current practice location is 1100 Lexington Ave Ste 400, Fort Smith, Arkansas. You can reach out to her office (for appointments etc.) via phone at (877) 522-1275.

Amy Declerk is licensed to practice in Arkansas (license number A004229) 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 1518362227.

Contact Information

	Amy Declerk, APRN
	1100 Lexington Ave Ste 400, Fort Smith, AR 72901-5170
	(877) 522-1275
	(509) 491-3031

Map and Direction

Provider's Profile

Full Name	Amy Declerk
Gender	Female
Speciality	Nurse Practitioner
Experience	12 Years
Location	1100 Lexington Ave Ste 400, Fort Smith, Arkansas
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:

Amy Declerk graduated from nursing school in 2014

NPI Data:

NPI Number: 1518362227
Provider Enumeration Date: 10/24/2014
Last Update Date: 02/26/2025

Medicare PECOS Information:

PECOS PAC ID: 8527389451
Enrollment ID: I20150604000651

Medical Identifiers

Medical identifiers for Amy Declerk such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1518362227	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP2300X	Nurse Practitioner - Primary Care	F1014430 (Arkansas)	Secondary
363LF0000X	Nurse Practitioner - Family	A004229 (Arkansas)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Ideal Telemedicine Services Llc	2860726221	58
Ideal Option Pllc	6709013105	94

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. Amy Declerk allows following entities to bill medicare on her behalf.

Entity Name	Medexpress Urgent Care Arkansas Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1578984357 PECOS PAC ID: 7012132293 Enrollment ID: O20140701002053

Entity Name	Ideal Option Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1457788275 PECOS PAC ID: 6709013105 Enrollment ID: O20200220002283

Entity Name	Ideal Telemedicine Services Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1346754868 PECOS PAC ID: 2860726221 Enrollment ID: O20200311000756

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. Amy Declerk 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
Amy Declerk, APRN 500 Sw 7th St Ste A205, Renton, WA 98057-2983 Ph: (877) 522-1275	Amy Declerk, APRN 1100 Lexington Ave Ste 400, Fort Smith, AR 72901-5170 Ph: (877) 522-1275

Reviews and Comments

Nurse Practitioner Nurses in Fort Smith, AR

Valentina Nastasi, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7600 Rogers Ave, Fort Smith, AR 72903 Phone: 479-226-8340
Mrs. Tonya Renea Allen, APRN, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3112 S 70th St, Fort Smith, AR 72903 Phone: 479-452-8600
Mandi T Williams, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 7217 Cameron Park Dr, Fort Smith, AR 72903 Phone: 479-831-6007 Fax: 479-782-1242
Tracy Lynn Fisher, APN, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4900 Kelley Hwy, Fort Smith, AR 72904 Phone: 479-785-5700 Fax: 479-785-5708
Mrs. Athena Frangos-pasley, APN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1500 Dodson Ave, Fort Smith, AR 72901 Phone: 479-709-6850
Mrs. Gayla Denise Johnson, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7301 Rogers Ave, Fort Smith, AR 72903 Phone: 479-484-6000
Dabney Herrold, MSN, APRN, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3420 S 74th St, Fort Smith, AR 72903 Phone: 479-573-3740

Amy Declerk, APRN - Medicare Nurse Practitioner in Fort Smith, AR