Anthony Clark, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" physician in Canton, Ohio. He graduated from medical school in 1996 and has 28 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Aultman Deuble Heart And Vascular Hospital, Llc, Ohio Hospital-based Physicians Corporation and his current practice location is
2600 Sixth Street Sw, Ohio Hospital Based Physician Corp, Canton, Ohio. You can reach out to his office (for appointments etc.) via phone at
(330) 363-7462.
Anthony Clark is licensed to practice in Ohio (license number APRN.CRNA.03168) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1013964089.
Physician's Profile
| Full Name | Anthony Clark |
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| Gender | Male |
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| Speciality | Certified Registered Nurse Anesthetist (crna) |
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| Experience | 28 Years |
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| Location | 2600 Sixth Street Sw, Canton, Ohio |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Anthony Clark graduated from medical school in 1996
NPI Data:
- NPI Number: 1013964089
- Provider Enumeration Date: 05/27/2006
- Last Update Date: 07/19/2022
Medicare PECOS Information:
- PECOS PAC ID: 7810022910
- Enrollment ID: I20100315000564
Medical Identifiers
Medical identifiers for Anthony Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1013964089 | NPI | - | NPPES |
| 2113779 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207L00000X | Anesthesiology | KN237880 (Ohio) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | APRN.CRNA.03168 (Ohio) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Aultman Deuble Heart And Vascular Hospital, Llc | 1850726126 | 91 |
| Ohio Hospital-based Physicians Corporation | 9133019110 | 67 |
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. Anthony Clark allows following entities to bill medicare on his behalf.
| Entity Name | Ohio Hospital-based Physicians Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1891727079
PECOS PAC ID: 9133019110
Enrollment ID: O20040316000515 |
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| Entity Name | Aultman Deuble Heart & Vascular Hospital, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1306495718
PECOS PAC ID: 1850726126
Enrollment ID: O20200114002347 |
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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. Anthony 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 |
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Anthony Clark, CRNA
Po Box 80690,
Canton, OH 44708-0690
Ph: (330) 363-7444 | Anthony Clark, CRNA
2600 Sixth Street Sw, Ohio Hospital Based Physician Corp,
Canton, OH 44710
Ph: (330) 363-7462 |
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