Matthew David Ayers Clark, PSYD, FLP in Caledonia, MI

Matthew David Ayers Clark, PSYD, FLP is a medicare enrolled "Psychologist" provider in Caledonia, Michigan. His current practice location is 7150 Kalamazoo Ave Se, Ste C, Caledonia, Michigan. You can reach out to his office (for appointments etc.) via phone at (616) 690-5437.

Matthew David Ayers Clark is licensed to practice in Michigan (license number 6301013305) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1811001126.

Contact Information

	Matthew David Ayers Clark, PSYD, FLP
	7150 Kalamazoo Ave Se, Ste C, Caledonia, MI 49316-9126
	(616) 690-5437
	(616) 825-6225

Map and Direction

Healthcare Provider's Profile

Full Name	Matthew David Ayers Clark
Gender	Male
Speciality	Psychologist
Location	7150 Kalamazoo Ave Se, Caledonia, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1811001126
Provider Enumeration Date: 08/17/2006
Last Update Date: 01/16/2019

Medicare PECOS Information:

PECOS PAC ID: 8921004615
Enrollment ID: I20061020000391

Medical Identifiers

Medical identifiers for Matthew David Ayers Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1811001126	NPI	-	NPPES
D16189090	Other	MI	MEDICARE
0897749	Other	MI	BLUE CROSS BLUE SHIELD

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	6301013305 (Michigan)	Secondary
103T00000X	Psychologist	6301013305 (Michigan)	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. Matthew David Ayers Clark allows following entities to bill medicare on his behalf.

Entity Name	Clark Institute Psychology Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1508339524 PECOS PAC ID: 9436495298 Enrollment ID: O20190115003185

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. Matthew David Ayers 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
Matthew David Ayers Clark, PSYD, FLP 7150 Kalamazoo Ave Se, Ste C, Caledonia, MI 49316-9126 Ph: (616) 690-5437	Matthew David Ayers Clark, PSYD, FLP 7150 Kalamazoo Ave Se, Ste C, Caledonia, MI 49316-9126 Ph: (616) 690-5437

Reviews and Comments

Psychologist in Caledonia, MI

Graceann Mary Robertson, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 7150 Kalamazoo Ave Se Ste C, Caledonia, MI 49316 Phone: 616-219-0159 Fax: 616-219-0124
Mrs. Susan Lee Alderink-hulst, MA, LLP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3178 68th St Se, Suite C, Caledonia, MI 49316 Phone: 616-803-0643
Ms. Victoria Pelton, MA, LLP, CAADC Psychologist Medicare: Not Enrolled in Medicare Practice Location: 7199 Kalamazoo Ave Se Ste 232, Caledonia, MI 49316 Phone: 616-803-9422 Fax: 616-277-7141
Mrs. Takara Taylor, LLP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 6505 Cherry Meadow Dr Se, Caledonia, MI 49316 Phone: 616-891-8770
Alexis Karamol, LLP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 7150 Kalamazoo Ave Se Ste C, Caledonia, MI 49316 Phone: 616-219-0159 Fax: 616-219-0124
Julie Smithee, PHD Psychologist Medicare: Medicare Enrolled Practice Location: 7150 Kalamazoo Ave Se Ste C, Caledonia, MI 49316 Phone: 616-550-2111
Jane E Oudbier, MA,LLP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 6265 Cherry View Est Se, Caledonia, MI 49316 Phone: 616-891-1103

Matthew David Ayers Clark, PSYD, FLP - Medicare Psychologist in Caledonia, MI