Derek William Clark, MD in Portland, OR

Derek William Clark, MD is a medicare enrolled "Psychiatry & Neurology - Neurocritical Care" physician in Portland, Oregon. He went to West Virginia University School Of Medicine and graduated in 2010 and has 14 years of diverse experience with area of expertise as Neurology. He is a member of the group practice Providence Health And Services Oregon and his current practice location is 9135 Sw Barnes Rd Ste 461, Portland, Oregon. You can reach out to his office (for appointments etc.) via phone at (503) 216-1150.

Derek William Clark is licensed to practice in Oregon (license number MD158550) 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 1518283589.

Contact Information

	Derek William Clark, MD
	9135 Sw Barnes Rd Ste 461, Portland, OR 97225-6643
	(503) 216-1150
	Not Available

Map and Direction

Physician's Profile

Full Name	Derek William Clark
Gender	Male
Speciality	Neurology
Experience	14 Years
Location	9135 Sw Barnes Rd Ste 461, Portland, Oregon
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Derek William Clark attended and graduated from West Virginia University School Of Medicine in 2010

NPI Data:

NPI Number: 1518283589
Provider Enumeration Date: 04/15/2010
Last Update Date: 11/25/2022

Medicare PECOS Information:

PECOS PAC ID: 1153576962
Enrollment ID: I20140519001422

Medical Identifiers

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

Identifier	Type	State	Issuer
1518283589	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2084N0400X	Psychiatry & Neurology - Neurology	MD60658145 (Washington)	Secondary
2084N0400X	Psychiatry & Neurology - Neurology	MD158550 (Oregon)	Secondary
2084A2900X	Psychiatry & Neurology - Neurocritical Care	MD158550 (Oregon)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Providence Portland Medical Center	Portland, OR	Hospital
Providence St Vincent Medical Center	Portland, OR	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Providence Health And Services Oregon	0648183608	1344

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. Derek William Clark allows following entities to bill medicare on his behalf.

Entity Name	Providence Health & Services Oregon
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1023488343 PECOS PAC ID: 0648183608 Enrollment ID: O20031106000652

Entity Name	Providence Health & Services Oregon
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1003991845 PECOS PAC ID: 5395656284 Enrollment ID: O20031113000626

Entity Name	Providence Health & Services Oregon
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1114015971 PECOS PAC ID: 9335057447 Enrollment ID: O20031117000153

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. Derek William 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
Derek William Clark, MD Po Box 3158, Portland, OR 97208-3158 Ph: (503) 215-6494	Derek William Clark, MD 9135 Sw Barnes Rd Ste 461, Portland, OR 97225-6643 Ph: (503) 216-1150

Reviews and Comments

Psychiatry & Neurology Doctors in Portland, OR

Mikel Matto, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 2214 Lloyd Ctr, Portland, OR 97232 Phone: 503-494-4222 Fax: 503-494-6143
William James Hoppe, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 13303 Nw Springville Rd, Portland, OR 97229 Phone: 503-910-2664
Dr. Robert Gene Mealer, M.D., PH.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-494-6176 Fax: 503-494-6152
Karina Rae Espana, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-494-8311
Dr. David Morrison Douglas, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 3710 Sw Us Veterans Hospital Rd, Portland, OR 97239 Phone: 503-721-1440
Margaret S Cary, MD, MPH Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 3181 Sw Sam Jackson Park Rd, Mail Code Dc7p, Portland, OR 97239 Phone: 503-418-5775 Fax: 503-418-5774
Dr. Melissa Beth Buboltz, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 3181 Sw Sam Jackson Park Rd, Uhn 80, Portland, OR 97239 Phone: 503-494-8311

Derek William Clark, MD - Medicare Neurology in Portland, OR