Jay Clark, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Christiansburg, Virginia. His current practice location is
2900 Lamb Cir, Christiansburg, Virginia. You can reach out to his office (for appointments etc.) via phone at
(540) 731-2000.
Jay Clark is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1508486077.
Physician's Profile
Full Name | Jay Clark |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 2900 Lamb Cir, Christiansburg, Virginia |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1508486077
- Provider Enumeration Date: 04/24/2020
- Last Update Date: 07/18/2024
Medicare PECOS Information:
- PECOS PAC ID: 8224451679
- Enrollment ID: I20241107003037
Medical Identifiers
Medical identifiers for Jay Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1508486077 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208M00000X | Hospitalist | 0101282679 (Virginia) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | 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. Jay Clark allows following entities to bill medicare on his behalf.
Entity Name | Carilion Healthcare Corporation |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1447206370 PECOS PAC ID: 5890607253 Enrollment ID: O20031106000273 |
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Entity Name | Carilion Rockbridge Community Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1174636021 PECOS PAC ID: 4789658261 Enrollment ID: O20040820000838 |
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Entity Name | Carilion Giles Community Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1194718304 PECOS PAC ID: 3678670221 Enrollment ID: O20070516000487 |
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Entity Name | Carilion Medical Center |
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Entity Type | Part B Supplier - Hospital Department(s) |
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Entity Identifiers | NPI Number: 1649423815 PECOS PAC ID: 9830096585 Enrollment ID: O20090320000373 |
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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. Jay 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 |
Jay Clark, MD 213 S Jefferson St Ste 1006, Roanoke, VA 24011-1713 Ph: () - | Jay Clark, MD 2900 Lamb Cir, Christiansburg, VA 24073-6344 Ph: (540) 731-2000 |
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