Ashley Marie Clark Medina, PA-C is a medicare enrolled "Physician Assistant" physician in Charlotte, North Carolina. She went to Wake Forest University School Of Medicine and graduated in 2011 and has 13 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Mecklenburg Radiology Associates Pa and 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 | Physician Assistant |
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| Experience | 13 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. |
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Medical Education and Training:
- Ashley Marie Clark Medina attended and graduated from Wake Forest University School Of Medicine in 2011
NPI Data:
- NPI Number: 1720372790
- Provider Enumeration Date: 06/07/2011
- Last Update Date: 09/29/2020
Medicare PECOS Information:
- PECOS PAC ID: 5092986299
- Enrollment ID: I20130508000562
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 |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Mecklenburg Radiology Associates Pa | 6800789587 | 80 |
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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