Jonathan B Clark, CRNA in Providence, RI - Medicare Certified Registered Nurse Anesthetist (crna)

Jonathan B Clark, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Providence, Rhode Island. He graduated from nursing school in 2015 and has 10 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Capa Anesthesia Llc, Coastal Medical Associates, South Suburban Gastroenterology Pc and his current practice location is 164 Summit Ave, Providence, Rhode Island. You can reach out to his office (for appointments etc.) via phone at (401) 793-4575.

Jonathan B Clark is licensed to practice in Rhode Island (license number APRN00302) and he also participates in the medicare program. He may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1275923781.

Contact Information

	Jonathan B Clark, CRNA
	164 Summit Ave, Providence, RI 02906-2853
	(401) 793-4575
	Not Available

Map and Direction

Provider's Profile

Full Name	Jonathan B Clark
Gender	Male
Speciality	Certified Registered Nurse Anesthetist (crna)
Experience	10 Years
Location	164 Summit Ave, Providence, Rhode Island
Accepts Medicare Assignments	May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.

Medical Education and Training:

Jonathan B Clark graduated from nursing school in 2015

NPI Data:

NPI Number: 1275923781
Provider Enumeration Date: 02/04/2015
Last Update Date: 09/16/2021

Medicare PECOS Information:

PECOS PAC ID: 3476879313
Enrollment ID: I20150311001845

Medical Identifiers

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

Identifier	Type	State	Issuer
1275923781	NPI	-	NPPES
110106160A	Medicaid	MA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	RN277232 (Massachusetts)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	APRN00302 (Rhode Island)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
South Shore Hospital	South weymouth, MA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Capa Anesthesia Llc	1850786393	47
Coastal Medical Associates	7113029257	412
South Suburban Gastroenterology Pc	9931194412	36

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

Entity Name	South Suburban Gastroenterology Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1114948478 PECOS PAC ID: 9931194412 Enrollment ID: O20040415000288

Entity Name	Coastal Medical Associates
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1932175684 PECOS PAC ID: 7113029257 Enrollment ID: O20070221000057

Entity Name	Lawrence Anesthesia Services Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1467699918 PECOS PAC ID: 4082770136 Enrollment ID: O20090225000707

Entity Name	Capa Anesthesia Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1629723002 PECOS PAC ID: 1850786393 Enrollment ID: O20220318000777

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. Jonathan 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
Jonathan B Clark, CRNA 333 Ricciuti Dr, Apt. 1824, Quincy, MA 02169-6287 Ph: () -	Jonathan B Clark, CRNA 164 Summit Ave, Providence, RI 02906-2853 Ph: (401) 793-4575

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Providence, RI

Brian F Girard, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 593 Eddy Street, Davol 129, Providence, RI 02903 Phone: 401-444-4933 Fax: 401-444-5090
Peter W Wolferseder, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 593 Eddy Street, Davol 129, Providence, RI 02903 Phone: 401-444-4933 Fax: 401-444-5090
Marie A Mills, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 593 Eddy Street, Davol 129, Providence, RI 02903 Phone: 401-444-4933 Fax: 401-444-5090
Beth Vanpraag, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 593 Eddy Street, Davol 129, Providence, RI 02903 Phone: 401-444-4933 Fax: 401-444-5090
Paulette Champion, CRNA Nurse Anesthetist - CR Medicare: May Accept Medicare Assignments Practice Location: 593 Eddy St, Davol 129, Providence, RI 02903 Phone: 401-444-4933 Fax: 401-444-5090
Angela Thomas, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 593 Eddy Street, Davol 129, Providence, RI 02903 Phone: 401-444-4933 Fax: 401-444-5090
Garrick Mark Whitlock, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 825 Chalkstone Ave, Providence, RI 02908 Phone: 401-456-2000

Jonathan B Clark, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Providence, RI