Donald Lee Clark Iii, FNP-BC - Medicare Nurse Practitioner in Granite City, IL

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Donald Lee Clark Iii, FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Granite City, Illinois. His current practice location is 2100 Madison Ave, Granite City, Illinois. You can reach out to his office (for appointments etc.) via phone at (618) 798-3000.

Donald Lee Clark Iii is licensed to practice in Illinois (license number 209019719) 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 1366090573.

Contact Information

Donald Lee Clark Iii, FNP-BC
2100 Madison Ave,
Granite City, IL 62040-4713
(618) 798-3000
Not Available

Map and Direction




Provider's Profile

Full NameDonald Lee Clark Iii
GenderMale
SpecialityNurse Practitioner - Family
Location2100 Madison Ave, Granite City, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1366090573
  • Provider Enumeration Date: 08/30/2019
  • Last Update Date: 08/30/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 3971835786
  • Enrollment ID: I20191029000651

Medical Identifiers

Medical identifiers for Donald Lee Clark Iii such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1366090573NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 209019719 (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. Donald Lee Clark Iii allows following entities to bill medicare on his behalf.
Entity NameGranite City Hospitalist Services Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1669926424
PECOS PAC ID: 8527356591
Enrollment ID: O20161006000282
Entity NameGranite City Emergency Medicine Providers Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1861946626
PECOS PAC ID: 7012205784
Enrollment ID: O20161012001300
Entity NameEmergency Services Midwest Sc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1174024806
PECOS PAC ID: 2769746056
Enrollment ID: O20180515000619
Entity NameStatera Health Care Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1043874449
PECOS PAC ID: 0244565729
Enrollment ID: O20190708000284
Entity NameTrinity Medical Staffing Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1770103426
PECOS PAC ID: 1759712698
Enrollment ID: O20200511000598
Entity NameAhs Il Medical Group Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1659098101
PECOS PAC ID: 5496111676
Enrollment ID: O20230512001300

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. Donald Lee Clark Iii 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
Donald Lee Clark Iii, FNP-BC
8308 Burlington Dr,
Troy, IL 62294-4003

Ph: (618) 402-3946		Donald Lee Clark Iii, FNP-BC
2100 Madison Ave,
Granite City, IL 62040-4713

Ph: (618) 798-3000

Reviews and Comments


Nurse Practitioner Nurses in Granite City, IL

Kierstin Hancock, PMHNP
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Medicare: May Accept Medicare Assignments
Practice Location: 54 Northgate Industrial Dr, Granite City, IL 62040
Phone: 618-877-4420    
Stephanie King, FNP-BC
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Medicare: Accepting Medicare Assignments
Practice Location: 3732 Nameoki Rd, Granite City, IL 62040
Phone: 314-687-2735    
Mrs. Amanda Hemphill, FNP-BC
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 2120 Madison Ave, Suite 404, Granite City, IL 62040
Phone: 618-876-7515    
Diane M Schwind, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 2044 Madison Ave, Suite 15, Granite City, IL 62040
Phone: 618-451-1500    
Mary Brooks, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 2100 Madison Ave, Granite City, IL 62040
Phone: 618-798-3000    
Dr. Jaime Ann Campbell, DNP, PMHNP-BC
Nurse Practitioner
Medicare: May Accept Medicare Assignments
Practice Location: 50 Northgate Industrial Dr, Granite City, IL 62040
Phone: 618-512-1919    Fax: 618-512-1920
Julienne Carol Szlufik, APN
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 50 Northgate Industrial Dr, Granite City, IL 62040
Phone: 618-877-4420    

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.