Dr William Edward Clack, MD is a medicare enrolled "Dermatology" physician in Elmira, New York. He went to State University Of New York At Buffalo School Of Medicine and graduated in 1968 and has 56 years of diverse experience with area of expertise as Dermatology. He is a member of the group practice Arnot Ogden Medical Center and his current practice location is
200 Madison Ave Ste 2b, Elmira, New York. You can reach out to his office (for appointments etc.) via phone at
(607) 732-1310.
Dr William Edward Clack is licensed to practice in New York (license number 1181211) 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 1053490805.
Physician's Profile
| Full Name | Dr William Edward Clack |
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| Gender | Male |
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| Speciality | Dermatology |
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| Experience | 56 Years |
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| Location | 200 Madison Ave Ste 2b, Elmira, New York |
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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 William Edward Clack attended and graduated from State University Of New York At Buffalo School Of Medicine in 1968
NPI Data:
- NPI Number: 1053490805
- Provider Enumeration Date: 11/03/2006
- Last Update Date: 11/24/2020
Medicare PECOS Information:
- PECOS PAC ID: 9436351251
- Enrollment ID: I20120109000736
Medical Identifiers
Medical identifiers for Dr William Edward Clack such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1053490805 | NPI | - | NPPES |
| 00359366 | Medicaid | NY | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207N00000X | Dermatology | 1181211 (New York) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Arnot Ogden Medical Center | 5395798417 | 195 |
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 William Edward Clack allows following entities to bill medicare on his behalf.
| Entity Name | Arnot Ogden Medical Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1083605661
PECOS PAC ID: 5395798417
Enrollment ID: O20061003000664 |
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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 William Edward Clack 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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Dr William Edward Clack, MD
571 Saint Josephs Blvd Fl 2,
Elmira, NY 14901-3230
Ph: (607) 271-2050 | Dr William Edward Clack, MD
200 Madison Ave Ste 2b,
Elmira, NY 14901-3219
Ph: (607) 732-1310 |
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