Dr Stephen E Clark, MD is a medicare enrolled "Ophthalmology" physician in Perrysburg, Ohio. He went to Ohio State University College Of Medicine and graduated in 1991 and has 33 years of diverse experience with area of expertise as Ophthalmology. He is a member of the group practice Perrysburg Eye Center, Inc. and his current practice location is
28370 Kensington Ln, Suite A, Perrysburg, Ohio. You can reach out to his office (for appointments etc.) via phone at
(419) 874-3125.
Dr Stephen E Clark is licensed to practice in Ohio (license number 35063695) 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 1134122948.
Physician's Profile
| Full Name | Dr Stephen E Clark |
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| Gender | Male |
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| Speciality | Ophthalmology |
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| Experience | 33 Years |
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| Location | 28370 Kensington Ln, Perrysburg, Ohio |
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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:
- Dr Stephen E Clark attended and graduated from Ohio State University College Of Medicine in 1991
NPI Data:
- NPI Number: 1134122948
- Provider Enumeration Date: 05/24/2005
- Last Update Date: 05/10/2012
Medicare PECOS Information:
- PECOS PAC ID: 7911928445
- Enrollment ID: I20100820000035
Medical Identifiers
Medical identifiers for Dr Stephen E Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1134122948 | NPI | - | NPPES |
| 02272 | Other | OH | PARAMOUNT HEALTH CARE |
| 000000281826 | Other | OH | ANTHEM BLUE CROSS/SHIELD |
| 5814164 | Other | OH | AETNA |
| 0292679 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207W00000X | Ophthalmology | 35063695 (Ohio) | Primary |
| 207W00000X | Ophthalmology | 01041459A (Indiana) | Secondary |
| 207W00000X | Ophthalmology | 4301069901 (Michigan) | Secondary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Perrysburg Eye Center, Inc. | 2567483092 | 4 |
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 Stephen E Clark allows following entities to bill medicare on his behalf.
| Entity Name | Perrysburg Eye Center, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1366475139
PECOS PAC ID: 2567483092
Enrollment ID: O20051213000368 |
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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 Stephen E 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 Stephen E Clark, MD
28370 Kensington Ln, Suite A,
Perrysburg, OH 43551-4163
Ph: (419) 874-3125 | Dr Stephen E Clark, MD
28370 Kensington Ln, Suite A,
Perrysburg, OH 43551-4163
Ph: (419) 874-3125 |
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