Kelly Anne Clark, in Vestal, NY - Medicare Social Worker Provider

Kelly Anne Clark, is a medicare enrolled "Social Worker - Clinical" provider in Vestal, New York. Her current practice location is 1715 Castle Gardens Rd, Vestal, New York. You can reach out to her office (for appointments etc.) via phone at (607) 341-7017.

Kelly Anne Clark is licensed to practice in New York (license number 075351) 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 1073083788.

Contact Information

	Kelly Anne Clark,
	1715 Castle Gardens Rd, Vestal, NY 13850-1175
	(607) 341-7017
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Kelly Anne Clark
Gender	Female
Speciality	Social Worker - Clinical
Location	1715 Castle Gardens Rd, Vestal, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1073083788
Provider Enumeration Date: 11/26/2018
Last Update Date: 11/26/2018

Medicare PECOS Information:

PECOS PAC ID: 6709124050
Enrollment ID: I20190211003069

Medical Identifiers

Medical identifiers for Kelly Anne Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1073083788	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	075351 (New York)	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. Kelly Anne Clark allows following entities to bill medicare on her behalf.

Entity Name	Our Lady Of Lourdes Memorial Hospital Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1629087580 PECOS PAC ID: 1254237779 Enrollment ID: O20031208000366

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. Kelly Anne 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
Kelly Anne Clark, 93 Park Ave, Binghamton, NY 13903-3226 Ph: (607) 321-5179	Kelly Anne Clark, 1715 Castle Gardens Rd, Vestal, NY 13850-1175 Ph: (607) 341-7017

Reviews and Comments

Social Worker in Vestal, NY

Ms. Tina Anne Folger, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 217 Raiford Rd, Vestal, NY 13850 Phone: 607-773-0034 Fax: 607-770-1916
Mrs. Bobbie Jo Deuel-lewis, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 116 Clayton Ave, Vestal, NY 13850 Phone: 607-754-1101
Jodi Sue Lowry, LCSW-R, ACSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3209 Vestal Pkwy E, Suite E, Vestal, NY 13850 Phone: 607-729-3003 Fax: 607-729-3004
Sasha Dora Fassett, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1040 Vestal Pkwy E, Vestal, NY 13850 Phone: 607-237-5411 Fax: 607-656-5691
Mr. Andrew Garrison Price, L.C.S.W. - R Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 9578 State Route 434, Vestal, NY 13850 Phone: 607-725-9107
Virginia Anne Bronson, LCSW-R Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 4513 Old Vestal Rd, Vestal, NY 13850 Phone: 607-427-9382 Fax: 607-729-6434

Kelly Anne Clark, - Medicare Clinical Social Worker in Vestal, NY