Roy Ellis Clark, MS, CCC-A in Columbus, IN - Medicare Audiologist Provider

Roy Ellis Clark, MS, CCC-A is a medicare enrolled "Audiologist" provider in Columbus, Indiana. His current practice location is 1655 N Gladstone Ave, Columbus, Indiana. You can reach out to his office (for appointments etc.) via phone at (812) 376-3071.

Roy Ellis Clark is licensed to practice in Indiana (license number 23002042) 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 1285808188.

Contact Information

	Roy Ellis Clark, MS, CCC-A
	1655 N Gladstone Ave, Columbus, IN 47201-5392
	(812) 376-3071
	(812) 378-5721

Map and Direction

Healthcare Provider's Profile

Full Name	Roy Ellis Clark
Gender	Male
Speciality	Audiologist
Location	1655 N Gladstone Ave, Columbus, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1285808188
Provider Enumeration Date: 04/22/2008
Last Update Date: 04/22/2008

Medicare PECOS Information:

PECOS PAC ID: 2860561545
Enrollment ID: I20080521000307

Medical Identifiers

Medical identifiers for Roy Ellis Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1285808188	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
231H00000X	Audiologist	23002042 (Indiana)	Primary
237600000X	Audiologist-hearing Aid Fitter	23002042 (Indiana)	Secondary

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. Roy Ellis Clark allows following entities to bill medicare on his behalf.

Provider Name	Otolaryngology Specialty Care Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1730440108 PECOS PAC ID: 2264697630 Enrollment ID: O20120710000411

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. Roy Ellis 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
Roy Ellis Clark, MS, CCC-A 1655 N Gladstone Ave, Columbus, IN 47201-5392 Ph: (812) 376-3071	Roy Ellis Clark, MS, CCC-A 1655 N Gladstone Ave, Columbus, IN 47201-5392 Ph: (812) 376-3071

Reviews and Comments

Audiologist in Columbus, IN

Danielle Hewitt, M.A., CCC-A Audiologist Medicare: Not Enrolled in Medicare Practice Location: 3015 10th St, Columbus, IN 47201 Phone: 812-376-5695 Fax: 812-375-3702
Hear Again Columbus Llc Audiologist Medicare: Medicare Enrolled Practice Location: 3130 N National Rd, Columbus, IN 47201 Phone: 000-000-0000
Dr. Jessica R Harvey, AUD Audiologist Medicare: Accepting Medicare Assignments Practice Location: 3105 Middle Rd Ste B, Columbus, IN 47203 Phone: 812-372-1886 Fax: 812-372-8156
Elaine Ketner, M.A.,CCC-A Audiologist Medicare: Not Enrolled in Medicare Practice Location: 1202 California St, Columbus, IN 47201 Phone: 812-376-6593 Fax: 812-375-9368
Jill Stephanie Lodde Greives, AU.D. Audiologist Medicare: Not Enrolled in Medicare Practice Location: 1655 N Gladstone Ave, Suite E, Columbus, IN 47201 Phone: 812-376-3071
Dr. Kristi M. Conner, AU.D. Audiologist Medicare: Accepting Medicare Assignments Practice Location: 2475 Northpark Dr Ste 10, Columbus, IN 47203 Phone: 812-372-1886 Fax: 812-372-8156

Roy Ellis Clark, MS, CCC-A - Medicare Audiologist in Columbus, IN