Eliza Gunn Clark, DPT in American Fork, UT - Medicare Physical Therapist Provider

Eliza Gunn Clark, DPT is a medicare enrolled "Physical Therapist" provider in American Fork, Utah. Her current practice location is 98 N 1100 E Ste 402, American Fork, Utah. You can reach out to her office (for appointments etc.) via phone at (801) 492-2405.

Eliza Gunn Clark is licensed to practice in Connecticut (license number 14032) 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 1376204636.

Contact Information

	Eliza Gunn Clark, DPT
	98 N 1100 E Ste 402, American Fork, UT 84003-2951
	(801) 492-2405
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Eliza Gunn Clark
Gender	Female
Speciality	Physical Therapist
Location	98 N 1100 E Ste 402, American Fork, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1376204636
Provider Enumeration Date: 01/07/2022
Last Update Date: 08/10/2023

Medicare PECOS Information:

PECOS PAC ID: 5597127514
Enrollment ID: I20230808002542

Medical Identifiers

Medical identifiers for Eliza Gunn Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1376204636	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	12615494-2401 (Utah)	Secondary
225100000X	Physical Therapist	14032 (Connecticut)	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. Eliza Gunn Clark allows following entities to bill medicare on her behalf.

Provider Name	Access Physical Therapy & Wellness Llc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1659819241 PECOS PAC ID: 8426317595 Enrollment ID: O20180117002504

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. Eliza Gunn 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
Eliza Gunn Clark, DPT 758 E 900 N Apt 106, Provo, UT 84606-2105 Ph: (412) 716-0133	Eliza Gunn Clark, DPT 98 N 1100 E Ste 402, American Fork, UT 84003-2951 Ph: (801) 492-2405

Reviews and Comments

Physical Therapist in American Fork, UT

Nickolas Arbon, Physical Therapist Medicare: Medicare Enrolled Practice Location: 358 N 1100 E # 4, American Fork, UT 84003 Phone: 385-304-4446
Quintin D Warnick, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 170 N 1100 E, American Fork, UT 84003 Phone: 801-763-3520
Russell Jack Gatenby, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1184 E 80 N, American Fork, UT 84003 Phone: 801-756-7777
Barbara B Moe, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 169 N 1100 E, American Fork, UT 84003 Phone: 801-472-2622
Dr. Peter Franklin Fitts, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 170 N 1100 E, American Fork, UT 84003 Phone: 801-855-3300
Mr. Jesse Adam Craig, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 170 N 1100 E, American Fork, UT 84003 Phone: 801-855-3437
Mr. Derick J Woolf, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 170 N 1100 E, American Fork, UT 84003 Phone: 801-763-3520

Eliza Gunn Clark, DPT - Medicare Physical Therapist in American Fork, UT