Jennifer Alexandria Clark, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in San Rafael, California. She graduated from nursing school in 2010 and has 14 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Anesthesia And Analgesia Medical Group Inc, Permanente Medical Group Inc and her current practice location is
99 Montecillo Rd, San Rafael, California. You can reach out to her office (for appointments etc.) via phone at
(925) 229-7693.
Jennifer Alexandria Clark is licensed to practice in California (license number 086522) 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 1023315231.
Provider's Profile
| Full Name | Jennifer Alexandria Clark |
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| Gender | Female |
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| Speciality | Certified Registered Nurse Anesthetist (crna) |
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| Experience | 14 Years |
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| Location | 99 Montecillo Rd, San Rafael, California |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Jennifer Alexandria Clark graduated from nursing school in 2010
NPI Data:
- NPI Number: 1023315231
- Provider Enumeration Date: 02/24/2011
- Last Update Date: 01/11/2022
Medicare PECOS Information:
- PECOS PAC ID: 4981877917
- Enrollment ID: I20111107000752
Medical Identifiers
Medical identifiers for Jennifer Alexandria Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1023315231 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 367500000X | Nurse Anesthetist, Certified Registered | 086522 (California) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Anesthesia And Analgesia Medical Group Inc | 1153316112 | 73 |
| Permanente Medical Group Inc | 8921910225 | 7800 |
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. Jennifer Alexandria Clark allows following entities to bill medicare on her behalf.
| Entity Name | Permanente Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073606299
PECOS PAC ID: 8921910225
Enrollment ID: O20031104000710 |
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| Entity Name | Anesthesia & Analgesia Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1659320984
PECOS PAC ID: 1153316112
Enrollment ID: O20040419000685 |
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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. Jennifer Alexandria 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 |
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Jennifer Alexandria Clark,
20 Barneson Ave, #c,
San Mateo, CA 94402-2978
Ph: (310) 266-2796 | Jennifer Alexandria Clark,
99 Montecillo Rd,
San Rafael, CA 94903-3308
Ph: (925) 229-7693 |
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