Randolph A Clark, MD in Phoenix, AZ - Medicare Internal Medicine

Randolph A Clark, MD is a medicare enrolled "Internal Medicine" physician in Phoenix, Arizona. He went to University Of Southern California Keck School Of Medicine and graduated in 1998 and has 26 years of diverse experience with area of expertise as Internal Medicine. He is a member of the group practice Pine Park Health, Inc, Clark Medical And Post-acute Services Llc and his current practice location is 2510 W Dunlap Ave Ste 290, Phoenix, Arizona. You can reach out to his office (for appointments etc.) via phone at (602) 789-0344.

Randolph A Clark is licensed to practice in Arizona (license number 27792) 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 1568456036.

Contact Information

	Randolph A Clark, MD
	2510 W Dunlap Ave Ste 290, Phoenix, AZ 85021-2759
	(602) 789-0344
	(602) 789-8389

Map and Direction

Physician's Profile

Full Name	Randolph A Clark
Gender	Male
Speciality	Internal Medicine
Experience	26 Years
Location	2510 W Dunlap Ave Ste 290, Phoenix, Arizona
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:

Randolph A Clark attended and graduated from University Of Southern California Keck School Of Medicine in 1998

NPI Data:

NPI Number: 1568456036
Provider Enumeration Date: 09/09/2005
Last Update Date: 05/04/2023

Medicare PECOS Information:

PECOS PAC ID: 7517916463
Enrollment ID: I20081203000150

Medical Identifiers

Medical identifiers for Randolph A Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1568456036	NPI	-	NPPES
648751	Medicaid	AZ

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	27792 (Arizona)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Connected Hospice	Portland, OR	Hospice
Banner Desert Medical Center	Mesa, AZ	Hospital
Summit Healthcare Regional Medical Center	Show low, AZ	Hospital
Haven Of Lakeside	Lakeside, AZ	Nursing home
Haven Of Sedona	Sedona, AZ	Nursing home
Haven Of Show Low	Show low, AZ	Nursing home
Friendship Village Of Tempe	Tempe, AZ	Nursing home
Desert Haven Care Center	Phoenix, AZ	Nursing home

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Pine Park Health, Inc	0345670527	28
Clark Medical And Post-acute Services Llc	5991164402	4

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. Randolph A Clark allows following entities to bill medicare on his behalf.

Entity Name	Pine Park Health, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1346879848 PECOS PAC ID: 0345670527 Enrollment ID: O20220928002530

Entity Name	Gaps Health Mi P.c.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1154943017 PECOS PAC ID: 6608297577 Enrollment ID: O20221213002811

Entity Name	Clark Medical And Post-acute Services Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1437851417 PECOS PAC ID: 5991164402 Enrollment ID: O20230630001989

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. Randolph A 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
Randolph A Clark, MD 2510 W Dunlap Ave Ste 290, Phoenix, AZ 85021-2759 Ph: (602) 789-0344	Randolph A Clark, MD 2510 W Dunlap Ave Ste 290, Phoenix, AZ 85021-2759 Ph: (602) 789-0344

Reviews and Comments

Internal Medicine Doctors in Phoenix, AZ

Moustafa I Hazin, D.O. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 500 W Thomas Rd, Suite 900, Phoenix, AZ 85013 Phone: 602-406-5590 Fax: 602-406-7165
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Dana Archbold, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1111 E Mcdowell Rd, Phoenix, AZ 85006 Phone: 602-839-2296 Fax: 602-839-2084
Dr. Nilofar Najafian, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 500 W Thomas Rd Ste 480, Phoenix, AZ 85013 Phone: 602-406-5483 Fax: 602-406-5488
Catalina Nicole Flores, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 350 W Thomas Rd Dept Of, Phoenix, AZ 85013 Phone: 602-406-3000
Kristina Yancey, Internal Medicine Medicare: Medicare Enrolled Practice Location: 5777 E Mayo Blvd, Phoenix, AZ 85054 Phone: 480-342-2000
Dr. Francisco Cordova, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 29 W Edgemont Ave, Phoenix, AZ 85003 Phone: 602-263-8971 Fax: 602-263-8971

Randolph A Clark, MD - Medicare Internal Medicine in Phoenix, AZ