Bradley J Clark, DO is a medicare enrolled "Pediatrics" physician in West Point, Utah. His current practice location is
145 S 3000 W, West Point, Utah. You can reach out to his office (for appointments etc.) via phone at
(801) 475-3960.
Bradley J Clark is licensed to practice in Utah (license number 9399538-1204) 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 1649532466.
Physician's Profile
Full Name | Bradley J Clark |
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Gender | Male |
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Speciality | Pediatrics |
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Location | 145 S 3000 W, West Point, Utah |
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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: 1649532466
- Provider Enumeration Date: 06/08/2012
- Last Update Date: 03/11/2024
Medicare PECOS Information:
- PECOS PAC ID: 9931332368
- Enrollment ID: I20150821014319
Medical Identifiers
Medical identifiers for Bradley J Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1649532466 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208000000X | Pediatrics | 9399538-1204 (Utah) | 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. Bradley J Clark allows following entities to bill medicare on his behalf.
Entity Name | Ogden Clinic Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1578550083 PECOS PAC ID: 9638078033 Enrollment ID: O20040105000780 |
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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. Bradley J 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 |
Bradley J Clark, DO Po Box 5546, Denver, CO 80217-5546 Ph: (801) 475-3500 | Bradley J Clark, DO 145 S 3000 W, West Point, UT 84015 Ph: (801) 475-3960 |
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