Crystal S Clark, in Monticello, IL - Medicare Nurse Practitioner

Crystal S Clark, is a medicare enrolled "Nurse Practitioner" in Monticello, Illinois. Her current practice location is 1000 Medical Center Dr, Monticello, Illinois. You can reach out to her office (for appointments etc.) via phone at (217) 762-6241.

Crystal S Clark is licensed to practice in Illinois (license number 209017069) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1427557321.

Contact Information

	Crystal S Clark,
	1000 Medical Center Dr, Monticello, IL 61856-2116
	(217) 762-6241
	(217) 762-1702

Map and Direction

Provider's Profile

Full Name	Crystal S Clark
Gender	Female
Speciality	Nurse Practitioner
Location	1000 Medical Center Dr, Monticello, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1427557321
Provider Enumeration Date: 02/06/2018
Last Update Date: 03/26/2019

Medicare PECOS Information:

PECOS PAC ID: 6305107939
Enrollment ID: I20180222002233

Medical Identifiers

Medical identifiers for Crystal S Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1427557321	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	209017069 (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. Crystal S Clark allows following entities to bill medicare on her behalf.

Entity Name	Kevin Elliott Counseling Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1255357422 PECOS PAC ID: 0143226860 Enrollment ID: O20061019000433

Entity Name	Promise Healthcare Nfp
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1578821005 PECOS PAC ID: 6103071345 Enrollment ID: O20130219000476

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. Crystal S 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
Crystal S Clark, 1000 Medical Center Dr, Monticello, IL 61856-2116 Ph: (217) 762-6241	Crystal S Clark, 1000 Medical Center Dr, Monticello, IL 61856-2116 Ph: (217) 762-6241

Reviews and Comments

Nurse Practitioner Nurses in Monticello, IL

Ms. Laci M Rascher, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1000 Medical Center Dr, Monticello, IL 61856 Phone: 217-762-6241 Fax: 217-762-1702
Amber Oberheim, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 100 W Washington St Ste 101, Monticello, IL 61856 Phone: 217-366-5434 Fax: 217-366-6106
Kelley Evans, NURSE PRACTITIONER Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1000 Medical Center Dr, Monticello, IL 61856 Phone: 217-762-6241 Fax: 217-762-1702
Jennifer Shawn Mahannah, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1000 Medical Center Dr, Monticello, IL 61856 Phone: 217-762-6241 Fax: 217-762-1702
Jennifer N Meinhart, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1000 Medical Center Dr, Monticello, IL 61856 Phone: 217-762-6241 Fax: 217-762-1702
Brittany Hicks, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 100 W Washington St Ste 101, Monticello, IL 61856 Phone: 217-762-3352

Crystal S Clark, - Medicare Nurse Practitioner in Monticello, IL