Dr Anna J Clark, OD is a medicare enrolled "Optometrist" provider in Colorado City, Colorado. Her current practice location is
4491 Bent Brothers Blvd., Colorado City, Colorado. You can reach out to her office (for appointments etc.) via phone at
(719) 676-3937.
Dr Anna J Clark is licensed to practice in Colorado (license number 2855) 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 1376831693.
Healthcare Provider's Profile
| Full Name | Dr Anna J Clark |
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| Gender | Female |
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| Speciality | Optometrist |
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| Location | 4491 Bent Brothers Blvd., Colorado City, Colorado |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1376831693
- Provider Enumeration Date: 07/20/2011
- Last Update Date: 12/20/2016
Medicare PECOS Information:
- PECOS PAC ID: 3375868532
- Enrollment ID: I20150210001428
Medical Identifiers
Medical identifiers for Dr Anna J Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1376831693 | NPI | - | NPPES |
| 00685232 | Medicaid | CO | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | 2855 (Colorado) | 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. Dr Anna J Clark allows following entities to bill medicare on her behalf.
| Provider Name | Rocky Mountain Eye Center Inc A Colorado Provider Network |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1073567459
PECOS PAC ID: 8325942089
Enrollment ID: O20040629000057 |
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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. Dr Anna J 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 |
|---|
Dr Anna J Clark, OD
Po Box 19366,
Colorado City, CO 81019-9366
Ph: (719) 676-3937 | Dr Anna J Clark, OD
4491 Bent Brothers Blvd.,
Colorado City, CO 81019-9366
Ph: (719) 676-3937 |
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