Carol Clark, in Royal Oak, MI - Medicare Emergency Medicine

Carol Clark, is a medicare enrolled "Emergency Medicine" physician in Royal Oak, Michigan. Her current practice location is 3601 W 13 Mile Rd, Ec, Royal Oak, Michigan. You can reach out to her office (for appointments etc.) via phone at (248) 898-0575.

Carol Clark is licensed to practice in Michigan (license number 4301050141) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1215996574.

Contact Information

	Carol Clark,
	3601 W 13 Mile Rd, Ec, Royal Oak, MI 48073-6712
	(248) 898-0575
	Not Available

Map and Direction

Physician's Profile

Full Name	Carol Clark
Gender	Female
Speciality	Emergency Medicine
Location	3601 W 13 Mile Rd, Royal Oak, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1215996574
Provider Enumeration Date: 03/23/2006
Last Update Date: 07/19/2022

Medicare PECOS Information:

PECOS PAC ID: 7416091020
Enrollment ID: I20100220000168

Medical Identifiers

Medical identifiers for Carol Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1215996574	NPI	-	NPPES
010F362410	Other	MI	BCBSM
2746544	Medicaid	MI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207P00000X	Emergency Medicine	4301050141 (Michigan)	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. Carol Clark allows following entities to bill medicare on her behalf.

Entity Name	Medical Center Emergency Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1902855711 PECOS PAC ID: 0648182071 Enrollment ID: O20031104000133

Entity Name	Emergency Department Physicians Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1225083595 PECOS PAC ID: 9436048998 Enrollment ID: O20040312000466

Entity Name	Michigan Emergency Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1316968191 PECOS PAC ID: 7315927894 Enrollment ID: O20040723001095

Entity Name	Beaumont Medical Group Hospital Based Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1427567858 PECOS PAC ID: 3072875889 Enrollment ID: O20180314001796

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. Carol 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
Carol Clark, 26901 Beaumont Blvd Ste 3d, Southfield, MI 48033-3849 Ph: () -	Carol Clark, 3601 W 13 Mile Rd, Ec, Royal Oak, MI 48073-6712 Ph: (248) 898-0575

Reviews and Comments

Emergency Medicine Doctors in Royal Oak, MI

Amit Bahl, MD, MPH Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 3601 W 13 Mile Rd, William Beaumont Hospital, Royal Oak, MI 48073 Phone: 248-898-0575 Fax: 248-898-4671
Dr. Kasey Curtis, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 3601 W 13 Mile Rd, Royal Oak, MI 48073 Phone: 248-898-5000
Dr. Kjerstin Hensley, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 3601 W 13 Mile Rd, Royal Oak, MI 48073 Phone: 248-898-5000
Raymond Jackson, Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 3601 W 13 Mile Rd, Ec, Royal Oak, MI 48073 Phone: 248-898-2015
David Poleski, Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 3601 W 13 Mile Rd, Ec, Royal Oak, MI 48073 Phone: 248-898-2934
Dr. Amy Smark, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 3601 W 13 Mile Rd, Department Of Emergency Medicine, Royal Oak, MI 48073 Phone: 248-898-1968
Dr. Yamen Nackoud, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 715 Butternut Ave, Royal Oak, MI 48073 Phone: 818-486-1511

Carol Clark, - Medicare Emergency Medicine in Royal Oak, MI