Clark Patrick Wise, MD in Columbia, SC

Clark Patrick Wise, MD is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Columbia, South Carolina. His current practice location is 1519 Marion St, Columbia, South Carolina. You can reach out to his office (for appointments etc.) via phone at (803) 296-5954.

Clark Patrick Wise is licensed to practice in South Carolina (license number 52527) 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 1619472354.

Contact Information

	Clark Patrick Wise, MD
	1519 Marion St, Columbia, SC 29201-2910
	(803) 296-5954
	(803) 296-3076

Map and Direction

Physician's Profile

Full Name	Clark Patrick Wise
Gender	Male
Speciality	Radiology - Diagnostic Radiology
Location	1519 Marion St, Columbia, South Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1619472354
Provider Enumeration Date: 03/26/2018
Last Update Date: 02/14/2024

Medicare PECOS Information:

PECOS PAC ID: 0648520866
Enrollment ID: I20231020002763

Medical Identifiers

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

Identifier	Type	State	Issuer
1619472354	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2085N0700X	Radiology - Neuroradiology	52527 (South Carolina)	Secondary
390200000X	Student In An Organized Health Care Education/training Program	(* (Not Available))	Secondary
2085R0202X	Radiology - Diagnostic Radiology	52527 (South Carolina)	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. Clark Patrick Wise allows following entities to bill medicare on his behalf.

Entity Name	University Medical Associates
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1043241110 PECOS PAC ID: 6305758574 Enrollment ID: O20031105000291

Entity Name	Prisma Health University Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1568799955 PECOS PAC ID: 8325950983 Enrollment ID: O20040108000041

Entity Name	Prisma Health University Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1730786096 PECOS PAC ID: 8325950983 Enrollment ID: O20201029000932

Entity Name	Musc Community Physicians
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1841878006 PECOS PAC ID: 6507260668 Enrollment ID: O20210811002388

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. Clark Patrick Wise 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
Clark Patrick Wise, MD 300 E Mcbee Ave Fl 4, Greenville, SC 29601-2842 Ph: (864) 522-8603	Clark Patrick Wise, MD 1519 Marion St, Columbia, SC 29201-2910 Ph: (803) 296-5954

Reviews and Comments

Radiology Doctors in Columbia, SC

Dr. Jason P Eastlack, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1519 Marion St, Columbia, SC 29201 Phone: 803-296-5954 Fax: 803-296-3076
Dr. James Joseph Farrell, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: Wjb Dorn Vamc, 6439 Garners Ferry Road, Columbia, SC 29209 Phone: 803-695-6811 Fax: 803-695-6745
Dr. Raleigh J Boulware, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 7 Medical Park, Suite 104, Columbia, SC 29223 Phone: 803-434-3400 Fax: 803-434-3938
Gerald Edmund Richmond, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 2000 Park St, Columbia, SC 29201 Phone: 803-462-3770 Fax: 803-462-3771
Dr. Robert Wesley Smith, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 5 Richland Medical Park Dr, Columbia, SC 29203 Phone: 803-434-7000
Nichole Holmes, RT(R, CT) Radiology Medicare: Not Enrolled in Medicare Practice Location: 6439 Garners Ferry Rd, Columbia, SC 29209 Phone: 803-776-4000
Mrs. Jennifer Cecile Wood, Radiology Medicare: Not Enrolled in Medicare Practice Location: 5 Richland Medical Park Dr, Columbia, SC 29203 Phone: 803-434-6766

Clark Patrick Wise, MD - Medicare Radiology in Columbia, SC