Gail A Clark, CNM in Fort Wayne, IN - Medicare Advanced Practice Midwife

Gail A Clark, CNM is a medicare enrolled "Advanced Practice Midwife" in Fort Wayne, Indiana. Her current practice location is 11123 Parkview Plaza Dr Ste 101, Fort Wayne, Indiana. You can reach out to her office (for appointments etc.) via phone at (260) 425-6650.

Gail A Clark is licensed to practice in Indiana (license number 09000192A) 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 1760718258.

Contact Information

	Gail A Clark, CNM
	11123 Parkview Plaza Dr Ste 101, Fort Wayne, IN 46845-1707
	(260) 425-6650
	(260) 425-6649

Map and Direction

Provider's Profile

Full Name	Gail A Clark
Gender	Female
Speciality	Advanced Practice Midwife
Location	11123 Parkview Plaza Dr Ste 101, Fort Wayne, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1760718258
Provider Enumeration Date: 10/19/2009
Last Update Date: 11/21/2023

Medicare PECOS Information:

PECOS PAC ID: 2769648112
Enrollment ID: I20120730000531

Medical Identifiers

Medical identifiers for Gail A Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1760718258	NPI	-	NPPES
815500500	Other	IN	MEDICARE PTAN
201044030	Medicaid	IN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367A00000X	Advanced Practice Midwife	71003121A (Indiana)	Secondary
367A00000X	Advanced Practice Midwife	09000192A (Indiana)	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. Gail A Clark allows following entities to bill medicare on her behalf.

Entity Name	Indiana University Health Ball Memorial Physicians Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1235455544 PECOS PAC ID: 9537072640 Enrollment ID: O20031110000505

Entity Name	Parkview Health System Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1932130952 PECOS PAC ID: 2163336967 Enrollment ID: O20031117000288

Entity Name	Arnett Clinic Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1164490843 PECOS PAC ID: 0749184380 Enrollment ID: O20031125000119

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. Gail A 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
Gail A Clark, CNM 250 N Shadeland Ave, Indianapolis, IN 46219-4959 Ph: () -	Gail A Clark, CNM 11123 Parkview Plaza Dr Ste 101, Fort Wayne, IN 46845-1707 Ph: (260) 425-6650

Reviews and Comments

Advanced Practice Midwife Nurses in Fort Wayne, IN

Sarah Michelle Moore, APRN-CNM, PMHNP-BC Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 909 E State Blvd, Fort Wayne, IN 46805 Phone: 260-481-2700 Fax: 260-481-2838
Mrs. Nicole Lynn Schwanz, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 10228 Dupont Circle Dr E Ste 100, Fort Wayne, IN 46825 Phone: 260-222-7401 Fax: 260-209-5956
Lisa M. Fedderke, MIDWIFE Advanced Practice Midwife Medicare: Accepting Medicare Assignments Practice Location: 11123 Parkview Plaza Dr, Fort Wayne, IN 46845 Phone: 260-425-6650 Fax: 260-425-6649
Marianne C Stroud, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 10228 Dupont Circle Dr E Ste 100, Fort Wayne, IN 46825 Phone: 602-227-4012 Fax: 260-209-5956
Andrea F Yoder, CNM Advanced Practice Midwife Medicare: Accepting Medicare Assignments Practice Location: 2518 E Dupont Rd, Fort Wayne, IN 46825 Phone: 260-432-4400 Fax: 260-969-6898
Allison A Thorpe, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 11123 Parkview Plaza Dr Ste 101, Fort Wayne, IN 46845 Phone: 260-422-7455 Fax: 260-422-4125
Clare Hall, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 10228 Dupont Circle Dr E, Fort Wayne, IN 46825 Phone: 260-222-7401

Gail A Clark, CNM - Medicare Advanced Practice Midwife in Fort Wayne, IN