Ashley Marie Clark Medina, PA-C is a medicare enrolled "Physician Assistant" physician in Charlotte, North Carolina. Her current practice location is
3623 Latrobe Dr Ste 216, Charlotte, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(704) 332-1291.
Ashley Marie Clark Medina is licensed to practice in North Carolina (license number 0010-04099) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1720372790.
Physician's Profile
Full Name | Ashley Marie Clark Medina |
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Gender | Female |
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Speciality | |
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Experience | Years |
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Location | 3623 Latrobe Dr Ste 216, Charlotte, North Carolina |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Ashley Marie Clark Medina attended and graduated from in
NPI Data:
- NPI Number: 1720372790
- Provider Enumeration Date: 06/07/2011
- Last Update Date: 09/29/2020
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Ashley Marie Clark Medina such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1720372790 | NPI | - | NPPES |
Y08KY | Other | FL | BLUE CROSS BLUE SHIELD |
133176 | Medicaid | AL | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2085R0204X | Radiology - Vascular & Interventional Radiology | 0010-04099 (North Carolina) | Secondary |
363A00000X | Physician Assistant | 0010-04099 (North Carolina) | Primary |
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. Ashley Marie Clark Medina 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 |
Ashley Marie Clark Medina, PA-C Po Box 221249, Mecklenburg Radiology Associates, Charlotte, NC 28222-1249 Ph: (704) 332-1291 | Ashley Marie Clark Medina, PA-C 3623 Latrobe Dr Ste 216, Charlotte, NC 28211 Ph: (704) 332-1291 |
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