Jenatte Virginia Clark, ARNP is a medicare enrolled "Dermatology" in Yakima, Washington. She graduated from nursing school in 2012 and has 12 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Jenatte Clark Dermatology Pllc and her current practice location is
4209 Tieton Dr Ste 102, Yakima, Washington. You can reach out to her office (for appointments etc.) via phone at
(509) 654-9810.
Jenatte Virginia Clark is licensed to practice in Washington (license number AP60329890) 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 1003250663.
Provider's Profile
| Full Name | Jenatte Virginia Clark |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 12 Years |
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| Location | 4209 Tieton Dr Ste 102, Yakima, Washington |
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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:
- Jenatte Virginia Clark graduated from nursing school in 2012
NPI Data:
- NPI Number: 1003250663
- Provider Enumeration Date: 04/24/2013
- Last Update Date: 11/10/2021
Medicare PECOS Information:
- PECOS PAC ID: 5698090082
- Enrollment ID: I20150205001543
Medical Identifiers
Medical identifiers for Jenatte Virginia Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1003250663 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | AP 60329890 (Washington) | Secondary |
| 207N00000X | Dermatology | AP60329890 (Washington) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Jenatte Clark Dermatology Pllc | 9739583436 | 2 |
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. Jenatte Virginia Clark allows following entities to bill medicare on her behalf.
| Entity Name | Jenatte Clark Dermatology Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1225601164
PECOS PAC ID: 9739583436
Enrollment ID: O20210803000677 |
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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. Jenatte Virginia 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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Jenatte Virginia Clark, ARNP
4209 Tieton Dr Ste 102,
Yakima, WA 98908-3377
Ph: (509) 654-9810 | Jenatte Virginia Clark, ARNP
4209 Tieton Dr Ste 102,
Yakima, WA 98908-3377
Ph: (509) 654-9810 |
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