Mr Clarence E Grim, MD in Las Vegas, NV - Medicare Internal Medicine

Mr Clarence E Grim, MD is a medicare enrolled "Internal Medicine - Geriatric Medicine" physician in Las Vegas, Nevada. His current practice location is 1180 N Town Center Dr Ste 100, Las Vegas, Nevada. You can reach out to his office (for appointments etc.) via phone at (414) 916-0841.

Mr Clarence E Grim is licensed to practice in Nevada (license number 14040) 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 1760404768.

Contact Information

	Mr Clarence E Grim, MD
	1180 N Town Center Dr Ste 100, Las Vegas, NV 89144-6308
	(414) 916-0841
	Not Available

Map and Direction

Physician's Profile

Full Name	Mr Clarence E Grim
Gender	Male
Speciality	Internal Medicine - Geriatric Medicine
Location	1180 N Town Center Dr Ste 100, Las Vegas, Nevada
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1760404768
Provider Enumeration Date: 07/25/2006
Last Update Date: 03/10/2020

Medicare PECOS Information:

PECOS PAC ID: 2668529884
Enrollment ID: I20090403000528

Medical Identifiers

Medical identifiers for Mr Clarence E Grim such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1760404768	NPI	-	NPPES
32093400	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207RE0101X	Internal Medicine - Endocrinology, Diabetes & Metabolism	36279 (Wisconsin)	Secondary
207R00000X	Internal Medicine	36279 (Wisconsin)	Secondary
207RG0300X	Internal Medicine - Geriatric Medicine	14040 (Nevada)	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. Mr Clarence E Grim allows following entities to bill medicare on his behalf.

Entity Name	Lakeshore Medical Clinic Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1003861188 PECOS PAC ID: 7719890730 Enrollment ID: O20031106000481

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. Mr Clarence E Grim 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
Mr Clarence E Grim, MD 195 Hwy 50, Suite #104, Pmb 7172-289, Stateline, NV 89449-7172 Ph: (414) 916-0841	Mr Clarence E Grim, MD 1180 N Town Center Dr Ste 100, Las Vegas, NV 89144-6308 Ph: (414) 916-0841

Reviews and Comments

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Mr Clarence E Grim, MD - Medicare Internal Medicine in Las Vegas, NV