Samantha Clark, MD is a medicare enrolled "Obstetrics & Gynecology" physician in Orrville, Ohio. She went to Northeastern Ohio University College Of Medicine and graduated in 2014 and has 10 years of diverse experience with area of expertise as Obstetrics/gynecology. She is a member of the group practice Ohio Physician Professional Corporation and her current practice location is
830 S Main St Ste 101, Orrville, Ohio. You can reach out to her office (for appointments etc.) via phone at
(330) 684-4797.
Samantha Clark is licensed to practice in Ohio (license number 35.132336) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1699186841.
Physician's Profile
| Full Name | Samantha Clark |
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| Gender | Female |
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| Speciality | Obstetrics/gynecology |
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| Experience | 10 Years |
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| Location | 830 S Main St Ste 101, Orrville, Ohio |
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| Accepts Medicare Assignments | Yes. She 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:
- Samantha Clark attended and graduated from Northeastern Ohio University College Of Medicine in 2014
NPI Data:
- NPI Number: 1699186841
- Provider Enumeration Date: 05/09/2014
- Last Update Date: 04/28/2022
Medicare PECOS Information:
- PECOS PAC ID: 8224253810
- Enrollment ID: I20181004001730
Medical Identifiers
Medical identifiers for Samantha Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1699186841 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207V00000X | Obstetrics & Gynecology | 35.132336 (Ohio) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Ohio Physician Professional Corporation | 2668406059 | 111 |
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. Samantha Clark allows following entities to bill medicare on her behalf.
| Entity Name | Orrville Hospital Foundation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1891718375
PECOS PAC ID: 7911890546
Enrollment ID: O20040206000004 |
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| Entity Name | Ohio Physician Professional Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1417016973
PECOS PAC ID: 2668406059
Enrollment ID: O20050925000062 |
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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. Samantha 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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Samantha Clark, MD
7570 Boneta Rd,
Wadsworth, OH 44281-8403
Ph: (330) 419-1019 | Samantha Clark, MD
830 S Main St Ste 101,
Orrville, OH 44667-2218
Ph: (330) 684-4797 |
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