Dr William S Clark, DO is a medicare enrolled "Emergency Medicine" physician in Escalon, California. He went to Chicago College Of Osteopathy and graduated in 2000 and has 24 years of diverse experience with area of expertise as Emergency Medicine. He is a member of the group practice Cep America - California and his current practice location is
1631 4th St, Escalon, California. You can reach out to his office (for appointments etc.) via phone at
(209) 838-3434.
Dr William S Clark is licensed to practice in California (license number 20A8748) 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 1770690430.
Physician's Profile
| Full Name | Dr William S Clark |
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| Gender | Male |
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| Speciality | Emergency Medicine |
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| Experience | 24 Years |
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| Location | 1631 4th St, Escalon, California |
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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 S Clark attended and graduated from Chicago College Of Osteopathy in 2000
NPI Data:
- NPI Number: 1770690430
- Provider Enumeration Date: 08/25/2006
- Last Update Date: 05/12/2022
Medicare PECOS Information:
- PECOS PAC ID: 4981593464
- Enrollment ID: I20041001000742
Medical Identifiers
Medical identifiers for Dr William S Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1770690430 | NPI | - | NPPES |
| 00AX87480 | Medicaid | CA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | 02002521A (Indiana) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 20A8748 (California) | Secondary |
| 208D00000X | General Practice | 20A8748 (California) | Secondary |
| 207P00000X | Emergency Medicine | 20A8748 (California) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Cep America - California | 6103739131 | 974 |
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 S Clark allows following entities to bill medicare on his behalf.
| Entity Name | Cep America - California |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1023063542
PECOS PAC ID: 6103739131
Enrollment ID: O20031106000520 |
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| Entity Name | Team Physicians Of California Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1447288345
PECOS PAC ID: 8224945084
Enrollment ID: O20040920000880 |
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| Entity Name | Clinic Services Of California Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1578958450
PECOS PAC ID: 7810209715
Enrollment ID: O20150707001394 |
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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 S 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 William S Clark, DO
1235 Mchenry Ave,
Modesto, CA 95350-5370
Ph: (818) 398-8527 | Dr William S Clark, DO
1631 4th St,
Escalon, CA 95320-2007
Ph: (209) 838-3434 |
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