Dr Janice Patrece Clark, DPM is a medicare enrolled "Podiatrist - Foot & Ankle Surgery" physician in Seattle, Washington. Her current practice location is
1660 S Columbian Way, Seattle, Washington. You can reach out to her office (for appointments etc.) via phone at
(206) 716-5651.
Dr Janice Patrece Clark is licensed to practice in Georgia (license number POD001114) 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 1811168339.
Physician's Profile
| Full Name | Dr Janice Patrece Clark |
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| Gender | Female |
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| Speciality | Podiatrist - Foot & Ankle Surgery |
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| Location | 1660 S Columbian Way, Seattle, Washington |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1811168339
- Provider Enumeration Date: 03/13/2008
- Last Update Date: 07/21/2022
Medicare PECOS Information:
- PECOS PAC ID: 3577631613
- Enrollment ID: I20230302001408
Medical Identifiers
Medical identifiers for Dr Janice Patrece Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1811168339 | NPI | - | NPPES |
| 519981 | Other | GA | WELLCARE |
| 52246038-001 | Other | GA | BCBSGA |
| PAR | Other | GA | AETNA |
| PAR-2009-07-20 | Other | GA | GREAT WEST |
| GPD114 | Medicaid | SC | |
| 2009-07-20 | Other | GA | CIGNA |
| 294861171A | Medicaid | GA | |
| 1289105 | Other | GA | AMERIGROUP |
| 2009-10-01 | Other | GA | PSHP |
| 20091544 | Other | GA | SELECT HEALTH |
| PAR-2009-08-28 | Other | GA | TRICARE |
| 2009-08-01 | Other | GA | UNITED HEALTHCARE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207XX0004X | Orthopaedic Surgery - Foot And Ankle Surgery | POD001114 (Georgia) | Secondary |
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | CL011 (New Mexico) | Secondary |
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 0689 (Arizona) | Secondary |
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | R57676 (New York) | Secondary |
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | POD001114 (Georgia) | 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. Dr Janice Patrece Clark allows following entities to bill medicare on her behalf.
| Entity Name | Seattle Indian Health Board |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1316012461
PECOS PAC ID: 7517866973
Enrollment ID: O20040105000550 |
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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. Dr Janice Patrece 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 |
|---|
Dr Janice Patrece Clark, DPM
Po Box 467,
Zuni, NM 87327-0467
Ph: (210) 842-6826 | Dr Janice Patrece Clark, DPM
1660 S Columbian Way,
Seattle, WA 98108-1532
Ph: (206) 716-5651 |
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