Clyde Grady, is a medicare enrolled "Family Medicine" physician in Knoxville, Illinois. He went to Southern Illinois University School Of Medicine and graduated in 1995 and has 29 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Southeast Iowa Regional Medical Center Inc, St Mary Medical Center and his current practice location is
104 S Broad St, Knoxville, Illinois. You can reach out to his office (for appointments etc.) via phone at
(309) 289-2335.
Clyde Grady is licensed to practice in Illinois (license number ) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1851484075.
Physician's Profile
| Full Name | Clyde Grady |
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| Gender | Male |
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| Speciality | Family Practice |
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| Experience | 29 Years |
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| Location | 104 S Broad St, Knoxville, Illinois |
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| Accepts Medicare Assignments | Yes. He 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:
- Clyde Grady attended and graduated from Southern Illinois University School Of Medicine in 1995
NPI Data:
- NPI Number: 1851484075
- Provider Enumeration Date: 10/02/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 9335278886
- Enrollment ID: I20240124000593
Medical Identifiers
Medical identifiers for Clyde Grady such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1851484075 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | (Illinois) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Southeast Iowa Regional Medical Center Inc | 3870496417 | 202 |
| St Mary Medical Center | 8628038015 | 50 |
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. Clyde Grady allows following entities to bill medicare on his behalf.
| Entity Name | Southeast Iowa Regional Medical Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1164433884
PECOS PAC ID: 3870496417
Enrollment ID: O20040130000139 |
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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. Clyde Grady 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 |
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Clyde Grady,
104 S Broad St,
Knoxville, IL 61448-1339
Ph: (309) 289-2335 | Clyde Grady,
104 S Broad St,
Knoxville, IL 61448-1339
Ph: (309) 289-2335 |
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