Dr Randil L Clark, MD is a medicare enrolled "Urology" physician in Coeur D' Alene, Idaho. He went to University Of California, Irvine, California College Of Medicine and graduated in 1985 and has 39 years of diverse experience with area of expertise as Urology. He is a member of the group practice North Idaho Urology Pllc and his current practice location is
980 Ironwood Dr W, Ste 104, Coeur D' Alene, Idaho. You can reach out to his office (for appointments etc.) via phone at
(208) 667-0621.
Dr Randil L Clark is licensed to practice in Idaho (license number M-5699) 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 1205961182.
Physician's Profile
| Full Name | Dr Randil L Clark |
|---|
| Gender | Male |
|---|
| Speciality | Urology |
|---|
| Experience | 39 Years |
|---|
| Location | 980 Ironwood Dr W, Coeur D' Alene, Idaho |
|---|
| 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:
- Dr Randil L Clark attended and graduated from University Of California, Irvine, California College Of Medicine in 1985
NPI Data:
- NPI Number: 1205961182
- Provider Enumeration Date: 02/22/2007
- Last Update Date: 05/25/2012
Medicare PECOS Information:
- PECOS PAC ID: 1153422894
- Enrollment ID: I20090407000147
Medical Identifiers
Medical identifiers for Dr Randil L Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1205961182 | NPI | - | NPPES |
| 002667200 | Medicaid | ID | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208800000X | Urology | M-5699 (Idaho) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| North Idaho Urology Pllc | 1456452291 | 9 |
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 Randil L Clark allows following entities to bill medicare on his behalf.
| Entity Name | Kootenai Health, Inc. |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1235288655
PECOS PAC ID: 4789641598
Enrollment ID: O20041214000230 |
|---|
| Entity Name | North Idaho Urology Pllc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1891834768
PECOS PAC ID: 1456452291
Enrollment ID: O20070724000658 |
|---|
| Entity Name | Kootenai Health Inc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1174661151
PECOS PAC ID: 1355792276
Enrollment ID: O20240111003252 |
|---|
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 Randil L 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 Randil L Clark, MD
980 Ironwood Dr W, Ste 104,
Coeur D' Alene, ID 83814
Ph: (208) 667-0621 | Dr Randil L Clark, MD
980 Ironwood Dr W, Ste 104,
Coeur D' Alene, ID 83814
Ph: (208) 667-0621 |
Reviews and Comments