Leo Jp Clark, MD is a medicare enrolled "Neurological Surgery" physician in Maumee, Ohio. He went to George Washington University School Of Medicine and graduated in 1970 and has 54 years of diverse experience with area of expertise as Neurosurgery. He is a member of the group practice Arnett Clinic Llc and his current practice location is
5705 Monclova Rd, Suite 204, Maumee, Ohio. You can reach out to his office (for appointments etc.) via phone at
(419) 891-8045.
Leo Jp Clark is licensed to practice in Ohio (license number 35039317C) 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 1659374007.
Physician's Profile
| Full Name | Leo Jp Clark |
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| Gender | Male |
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| Speciality | Neurosurgery |
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| Experience | 54 Years |
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| Location | 5705 Monclova Rd, Maumee, 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:
- Leo Jp Clark attended and graduated from George Washington University School Of Medicine in 1970
NPI Data:
- NPI Number: 1659374007
- Provider Enumeration Date: 05/31/2005
- Last Update Date: 01/12/2016
Medicare PECOS Information:
- PECOS PAC ID: 0648166918
- Enrollment ID: I20200211002427
Medical Identifiers
Medical identifiers for Leo Jp Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1659374007 | NPI | - | NPPES |
| 318954 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207T00000X | Neurological Surgery | 35039317C (Ohio) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Arnett Clinic Llc | 0749184380 | 382 |
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. Leo Jp Clark allows following entities to bill medicare on his behalf.
| Entity Name | Indiana University Health Ball Memorial Physicians Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1235455544
PECOS PAC ID: 9537072640
Enrollment ID: O20031110000505 |
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| Entity Name | Arnett Clinic Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1164490843
PECOS PAC ID: 0749184380
Enrollment ID: O20031125000119 |
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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. Leo Jp 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 |
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Leo Jp Clark, MD
1 Seagate, Suite 800,
Toledo, OH 43604-1558
Ph: (567) 585-1983 | Leo Jp Clark, MD
5705 Monclova Rd, Suite 204,
Maumee, OH 43537-1875
Ph: (419) 891-8045 |
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