Mr Fred Elton Clark Iii, MD in Saint Petersburg, FL

Mr Fred Elton Clark Iii, MD is a medicare enrolled "Family Medicine" physician in Saint Petersburg, Florida. He graduated from medical school in 2006 and has 19 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Legacy Healthcare Services Inc and his current practice location is 4401 4th St N, Saint Petersburg, Florida. You can reach out to his office (for appointments etc.) via phone at (727) 525-4401.

Mr Fred Elton Clark Iii is licensed to practice in Florida (license number ME102187) 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 1609022086.

Contact Information

	Mr Fred Elton Clark Iii, MD
	4401 4th St N, Saint Petersburg, FL 33703-4728
	(727) 525-4401
	(727) 525-7788

Map and Direction

Physician's Profile

Full Name	Mr Fred Elton Clark Iii
Gender	Male
Speciality	Family Practice
Experience	19 Years
Location	4401 4th St N, Saint Petersburg, Florida
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mr Fred Elton Clark Iii graduated from medical school in 2006

NPI Data:

NPI Number: 1609022086
Provider Enumeration Date: 08/18/2008
Last Update Date: 04/18/2017

Medicare PECOS Information:

PECOS PAC ID: 5092851212
Enrollment ID: I20091001000480

Medical Identifiers

Medical identifiers for Mr Fred Elton Clark Iii such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1609022086	NPI	-	NPPES
137000	Medicaid	FL
7A6EU	Other	FL	BCBS

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	ME102187 (Florida)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Grace Family Home Care	Clearwater, FL	Home health agency

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 Fred Elton Clark Iii allows following entities to bill medicare on his behalf.

Entity Name	Medical Home, Pl
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1629485271 PECOS PAC ID: 3274803259 Enrollment ID: O20170725000218

Entity Name	Waters Edge Medical Clinic Tampa Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1265054803 PECOS PAC ID: 0749691079 Enrollment ID: O20201118000070

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 Fred Elton Clark Iii 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 Fred Elton Clark Iii, MD 4401 4th St N, Saint Petersburg, FL 33703-4728 Ph: (727) 525-4401	Mr Fred Elton Clark Iii, MD 4401 4th St N, Saint Petersburg, FL 33703-4728 Ph: (727) 525-4401

Reviews and Comments

Family Medicine Doctors in Saint Petersburg, FL

Katherine Flachs Wojnowich, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 603 7th S St 440, Saint Petersburg, FL 33701 Phone: 727-893-6333 Fax: 727-553-7787
Mr. John Victor Sirois, APRN Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1500 22nd Ave N, Saint Petersburg, FL 33704 Phone: 860-716-5980
Mr. Julije Vucemilovic, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 6560 9th Ave N, Saint Petersburg, FL 33710 Phone: 727-384-4060
Dr. Alina Pollan, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 5798 38th Avenue North, Saint Petersburg, FL 33710 Phone: 727-384-0192 Fax: 727-384-1500
Luis Antonio Jovel, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2323 1st Ave N, Saint Petersburg, FL 33713 Phone: 727-327-5188 Fax: 727-321-3728
Marilyn Malia, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 6500 38th Ave N, Saint Petersburg, FL 33710 Phone: 727-384-7727
Bruce Warren Frieman, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 4930 Sandpiper Ln S, Saint Petersburg, FL 33711 Phone: 727-430-1037

Mr Fred Elton Clark Iii, MD - Medicare Family Practice in Saint Petersburg, FL