Cody Clark, - Medicare Certified Registered Nurse Anesthetist (crna) in Lebanon, PA

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Cody Clark, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Lebanon, Pennsylvania. He graduated from nursing school in 2016 and has 8 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Wellspan Medical Group and his current practice location is 252 S 4th St, Lebanon, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at (717) 270-7500.

Cody Clark is licensed to practice in Pennsylvania (license number RN626823) 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 1720442866.

Contact Information

Cody Clark,
252 S 4th St,
Lebanon, PA 17042-6111
(717) 270-7500
(717) 228-1642

Map and Direction




Provider's Profile

Full NameCody Clark
GenderMale
SpecialityCertified Registered Nurse Anesthetist (crna)
Experience8 Years
Location252 S 4th St, Lebanon, Pennsylvania
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Cody Clark graduated from nursing school in 2016
  NPI Data:
  • NPI Number: 1720442866
  • Provider Enumeration Date: 04/05/2016
  • Last Update Date: 10/28/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 2961793799
  • Enrollment ID: I20160624000878

Medical Identifiers

Medical identifiers for Cody Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1720442866NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered RN626823 (Pennsylvania)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Good Samaritan HospitalLebanon, PAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Wellspan Medical Group19512131151966

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. Cody Clark allows following entities to bill medicare on his behalf.
Entity NameLebanon Anesthesia Associates Ltd
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1407844079
PECOS PAC ID: 4688570997
Enrollment ID: O20031209000210
Entity NameWellspan Medical Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750480299
PECOS PAC ID: 1951213115
Enrollment ID: O20040220000815

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. Cody 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
Cody Clark,
3421 Concord Rd,
York, PA 17402-9001

Ph: (717) 270-7500		Cody Clark,
252 S 4th St,
Lebanon, PA 17042-6111

Ph: (717) 270-7500

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in Lebanon, PA

Ms. Lynee K Porter, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 912 Russell Drive, Lebanon, PA 17042
Phone: 717-272-9765    Fax: 717-272-9763
Mrs. Wanda Garrett Perez, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 252 S 4th St, Lebanon, PA 17042
Phone: 717-270-7500    Fax: 717-228-1642
Bridget Henderson, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 252 S 4th St, Lebanon, PA 17042
Phone: 717-228-1620    
Ashlee Wheeler, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 252 S 4th St, Lebanon, PA 17042
Phone: 717-270-7500    Fax: 717-228-1642
Meredith Anne Dinger, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 252 S 4th St, Lebanon, PA 17042
Phone: 717-270-7500    
Kathleen Mattes-longo, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 252 South 4th St, Lebanon, PA 17042
Phone: 717-272-4104    
Mrs. Rosette Marie Conkle, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 252 S 4th St, Lebanon, PA 17042
Phone: 717-270-7500    Fax: 717-228-1642

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.