Miss Dora K Clark, PA-C is a medicare enrolled "Physician Assistant" in West Warwick, Rhode Island. Her current practice location is
207 Quaker Ln, West Warwick, Rhode Island. You can reach out to her office (for appointments etc.) via phone at
(401) 828-7110.
Miss Dora K Clark is licensed to practice in Rhode Island (license number PA00430) 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 1760559033.
Provider's Profile
Full Name | Miss Dora K Clark |
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Gender | Female |
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Speciality | Physician Assistant |
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Location | 207 Quaker Ln, West Warwick, Rhode Island |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1760559033
- Provider Enumeration Date: 11/29/2006
- Last Update Date: 06/07/2024
Medicare PECOS Information:
- PECOS PAC ID: 7214036987
- Enrollment ID: I20080512000156
Medical Identifiers
Medical identifiers for Miss Dora K Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1760559033 | NPI | - | NPPES |
DC95067 | Medicaid | RI | |
P01280388 | Other | RI | RAILROAD MCR |
1760559033 | Other | RI | NEIGHBORHOOD HEALTH PLAN |
2509391 | Other | RI | COVENTRY |
7674984 | Other | RI | AETNA |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | PA00430 (Rhode Island) | Primary |
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. Miss Dora K 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 |
Miss Dora K Clark, PA-C 207 Quaker Ln, West Warwick, RI 02893-2283 Ph: (401) 828-7110 | Miss Dora K Clark, PA-C 207 Quaker Ln, West Warwick, RI 02893-2283 Ph: (401) 828-7110 |
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