Leslie A Clark, APRN in Port Orange, FL - Medicare Nurse Practitioner

Leslie A Clark, APRN is a medicare enrolled "Nurse Practitioner" in Port Orange, Florida. Her current practice location is 1730 Dunlawton Ave Ste 1, Port Orange, Florida. You can reach out to her office (for appointments etc.) via phone at (386) 320-3299.

Leslie A Clark is licensed to practice in Florida (license number APRN11009779) 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 1700482163.

Contact Information

	Leslie A Clark, APRN
	1730 Dunlawton Ave Ste 1, Port Orange, FL 32127-8986
	(386) 320-3299
	Not Available

Map and Direction

Provider's Profile

Full Name	Leslie A Clark
Gender	Female
Speciality	Nurse Practitioner
Location	1730 Dunlawton Ave Ste 1, Port Orange, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1700482163
Provider Enumeration Date: 12/09/2020
Last Update Date: 10/03/2022

Medicare PECOS Information:

PECOS PAC ID: 4082070677
Enrollment ID: I20230524002815

Medical Identifiers

Medical identifiers for Leslie A Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1700482163	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	APRN11009779 (Florida)	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. Leslie A Clark allows following entities to bill medicare on her behalf.

Entity Name	Sunshine Physicians Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1376998971 PECOS PAC ID: 2769772235 Enrollment ID: O20160613001112

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. Leslie A 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
Leslie A Clark, APRN 1730 Dunlawton Ave Ste 1, Port Orange, FL 32127-8986 Ph: (386) 320-3299	Leslie A Clark, APRN 1730 Dunlawton Ave Ste 1, Port Orange, FL 32127-8986 Ph: (386) 320-3299

Reviews and Comments

Nurse Practitioner Nurses in Port Orange, FL

Holly Anne Smith, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 870 Dunlawton Ave Ste 210a, Port Orange, FL 32127 Phone: 386-518-3671
Olivia Michelle Miller, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1690 Dunlawton Ave Ste 120, Port Orange, FL 32127 Phone: 386-271-2273 Fax: 386-271-2274
Lynn Ann Howard, ARNP, PMHNP, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 804 Dunlawton Ave, Port Orange, FL 32127 Phone: 386-767-8584 Fax: 386-767-8536
Jay W Butwinick, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1730 Dunlawton Ave Ste 1, Port Orange, FL 32127 Phone: 386-320-3299
Margaret M. Thompson, A.R.N.P., M.S.N Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 735 Dunlawton Ave, Port Orange, FL 32127 Phone: 888-808-0488 Fax: 386-872-4232
Kelly S Kiah, D.N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3800 Woodbriar Trl, Port Orange, FL 32129 Phone: 386-322-4752
Ms. Margaret Leger Ramstad, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1648 Taylor Rd Ste 259, Port Orange, FL 32128 Phone: 386-320-5525 Fax: 386-222-7395

Leslie A Clark, APRN - Medicare Nurse Practitioner in Port Orange, FL