Austin Jeremiah Sy Clark, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Sacramento, California. His current practice location is
2335 Stockton Blvd, North Addition 5th Floor, Sacramento, California. You can reach out to his office (for appointments etc.) via phone at
(916) 734-2724.
Austin Jeremiah Sy Clark is licensed to practice in New Mexico (license number RS2024-0223) 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 1811454184.
Physician's Profile
Full Name | Austin Jeremiah Sy Clark |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 2335 Stockton Blvd, Sacramento, California |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1811454184
- Provider Enumeration Date: 02/22/2019
- Last Update Date: 06/17/2024
Medicare PECOS Information:
- PECOS PAC ID: 1153771480
- Enrollment ID: I20231228000875
Medical Identifiers
Medical identifiers for Austin Jeremiah Sy Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1811454184 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208600000X | Surgery | A190369 (California) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | RS2024-0223 (New Mexico) | 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. Austin Jeremiah Sy Clark allows following entities to bill medicare on his behalf.
Entity Name | Skilled Facility Health Care Solutions Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1104018423 PECOS PAC ID: 9032299144 Enrollment ID: O20080102000273 |
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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. Austin Jeremiah Sy 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 |
Austin Jeremiah Sy Clark, MD 2335 Stockton Blvd, North Addition Building 5th Floor, Sacramento, CA 95817-2200 Ph: () - | Austin Jeremiah Sy Clark, MD 2335 Stockton Blvd, North Addition 5th Floor, Sacramento, CA 95817-2200 Ph: (916) 734-2724 |
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