Diane A Clark, CD in Beloit, WI - Medicare Dietitian, Registered Provider

Diane A Clark, CD is a medicare enrolled "Dietitian, Registered" provider in Beloit, Wisconsin. Her current practice location is Beloit Clinic, 1905 E. Huebbe Parkway, Beloit, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (608) 364-2293.

Diane A Clark is licensed to practice in Wisconsin (license number 2104-29) 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 1568055812.

Contact Information

	Diane A Clark, CD
	Beloit Clinic, 1905 E. Huebbe Parkway, Beloit, WI 53511-1842
	(608) 364-2293
	(608) 364-5452

Map and Direction

Healthcare Provider's Profile

Full Name	Diane A Clark
Gender	Female
Speciality	Dietitian, Registered
Location	Beloit Clinic, Beloit, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1568055812
Provider Enumeration Date: 02/18/2021
Last Update Date: 02/18/2021

Medicare PECOS Information:

PECOS PAC ID: 3072919307
Enrollment ID: I20210910001990

Medical Identifiers

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

Identifier	Type	State	Issuer
1568055812	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
133V00000X	Dietitian, Registered	2104-29 (Wisconsin)	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. Diane A Clark allows following entities to bill medicare on her behalf.

Provider Name	Beloit Health System Inc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1679616361 PECOS PAC ID: 8224947858 Enrollment ID: O20031215000424

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. Diane A 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
Diane A Clark, CD Beloit Clinic, 1905 E. Huebbe Parkway, Beloit, WI 53511-1842 Ph: (608) 364-2293	Diane A Clark, CD Beloit Clinic, 1905 E. Huebbe Parkway, Beloit, WI 53511-1842 Ph: (608) 364-2293

Reviews and Comments

Dietitian, Registered in Beloit, WI

Karlie Grace Wellnitz, RD CD Dietitian Medicare: Medicare Enrolled Practice Location: 1969 W Hart Rd, Beloit, WI 53511 Phone: 608-364-5011
Lauren Lee Moore, CD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1905 E Huebbe Pkwy, 1905 E. Huebbe Parkway, Beloit, WI 53511 Phone: 608-364-2200 Fax: 608-363-7395
Elizabeth Marie Wood, MS, RD, CD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1969 W Hart Rd, Beloit, WI 53511 Phone: 608-364-5011
Gretchen R Witowich, MS, RD, LDN Dietitian Medicare: Medicare Enrolled Practice Location: Beloit Clinic, 1905 E. Huebbe Parkway, Beloit, WI 53511 Phone: 608-364-2400 Fax: 608-364-1534
Victoria Flask, Dietitian Medicare: Medicare Enrolled Practice Location: 1969 W Hart Rd, Beloit, WI 53511 Phone: 608-634-5574
Ellen Mary Alice Rippl, CD Dietitian Medicare: Medicare Enrolled Practice Location: 1969 W Hart Rd, Beloit Memorial Hospital, Beloit, WI 53511 Phone: 608-364-5309 Fax: 608-364-1534
Samantha Jo Skowronski, CD Dietitian Medicare: Medicare Enrolled Practice Location: 1905 E Huebbe Pkwy, Beloit, WI 53511 Phone: 608-364-5545 Fax: 608-364-1534

Diane A Clark, CD - Medicare Dietitian in Beloit, WI