Matthew Clark, in Windsor, CT - Medicare Counselor Provider

Matthew Clark, is a medicare enrolled "Counselor - Professional" provider in Windsor, Connecticut. His current practice location is 360 Bloomfield Ave, Ste 301, Windsor, Connecticut. You can reach out to his office (for appointments etc.) via phone at (860) 607-3235.

Matthew Clark is licensed to practice in Connecticut (license number 002674) 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 1417353996.

Contact Information

	Matthew Clark,
	360 Bloomfield Ave, Ste 301, Windsor, CT 06095-2700
	(860) 607-3235
	(860) 607-3201

Map and Direction

Healthcare Provider's Profile

Full Name	Matthew Clark
Gender	Male
Speciality	Counselor - Professional
Location	360 Bloomfield Ave, Windsor, Connecticut
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1417353996
Provider Enumeration Date: 11/12/2014
Last Update Date: 01/05/2017

Medicare PECOS Information:

PECOS PAC ID: 4880031947
Enrollment ID: I20240325002708

Medical Identifiers

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

Identifier	Type	State	Issuer
1417353996	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	002674 (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. Matthew Clark allows following entities to bill medicare on his behalf.

Entity Name	Grow Healthcare Group Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220512000081

Entity Name	Clark Counseling Services, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1801332812 PECOS PAC ID: 3971940032 Enrollment ID: O20240325002430

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 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 Clark, 360 Bloomfield Ave, Ste 301, Windsor, CT 06095-2700 Ph: (860) 607-3235	Matthew Clark, 360 Bloomfield Ave, Ste 301, Windsor, CT 06095-2700 Ph: (860) 607-3235

Reviews and Comments

Counselor in Windsor, CT

Destiny Grant, Counselor Medicare: Not Enrolled in Medicare Practice Location: 995 Day Hill Rd, Windsor, CT 06095 Phone: 860-731-5522 Fax: 860-731-5536
Joyce A Erickson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1343 Hillside Cir, Windsor, CT 06095 Phone: 860-707-9438
Nardine Staroverov, Counselor Medicare: Not Enrolled in Medicare Practice Location: 32 Maple Ave Ste C, Windsor, CT 06095 Phone: 860-593-4908
Valerie Barrett-noel, Counselor Medicare: Medicare Enrolled Practice Location: 600 W Wolcott Ave, Windsor, CT 06095 Phone: 860-794-0652
Antonette Bailey, Counselor Medicare: Not Enrolled in Medicare Practice Location: 995 Day Hill Rd, Windsor, CT 06095 Phone: 860-731-5522 Fax: 860-731-5536
Mrs. Rosanna Z Wilson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1 Kellogg St, Windsor, CT 06095 Phone: 860-219-1029
Mr. Derek James Wilson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 360 Bloomfield Ave Ste 301, Windsor, CT 06095 Phone: 860-471-3819

Matthew Clark, - Medicare Counselor in Windsor, CT