Benjamin Clark, PMHNP-BC - Medicare Nurse Practitioner in Washington, IL

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Benjamin Clark, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Washington, Illinois. His current practice location is 1204 Kingsbury Rd, Washington, Illinois. You can reach out to his office (for appointments etc.) via phone at (309) 253-4519.

Benjamin Clark is licensed to practice in Illinois (license number 209029848) 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 1467298257.

Contact Information

Benjamin Clark, PMHNP-BC
1204 Kingsbury Rd,
Washington, IL 61571-1213
(309) 253-4519
Not Available

Map and Direction




Provider's Profile

Full NameBenjamin Clark
GenderMale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location1204 Kingsbury Rd, Washington, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1467298257
  • Provider Enumeration Date: 07/02/2024
  • Last Update Date: 07/15/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 4183155906
  • Enrollment ID: I20241004000101

Medical Identifiers

Medical identifiers for Benjamin Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1467298257NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0808XNurse Practitioner - Psychiatric/mental Health 209029848 (Illinois)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. Benjamin Clark allows following entities to bill medicare on his behalf.
Entity NameKnox Community Health Center Nfp
Entity TypePart A Provider - Federally Qualified Health Center (fqhc)
Entity IdentifiersNPI Number: 1649526773
PECOS PAC ID: 7618126327
Enrollment ID: O20121012000061
Entity NameKnox Community Health Center Nfp
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1649526773
PECOS PAC ID: 7618126327
Enrollment ID: O20130221000169

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. Benjamin 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 AddressPractice Location Address
Benjamin Clark, PMHNP-BC
1204 Kingsbury Rd,
Washington, IL 61571-1213

Ph: (309) 253-4519		Benjamin Clark, PMHNP-BC
1204 Kingsbury Rd,
Washington, IL 61571-1213

Ph: (309) 253-4519

Reviews and Comments


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Practice Location: 10 Saint Clare Ct, Washington, IL 61571
Phone: 309-886-4000    Fax: 309-886-4118

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.