Mr Michael Clark, NP - Medicare Nurse Practitioner in Providence, RI

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Mr Michael Clark, NP is a medicare enrolled "Nurse Practitioner" in Providence, Rhode Island. He graduated from nursing school in 2016 and has 8 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Brown Emergency Medicine and his current practice location is 593 Eddy St, Apc Suite 523, Providence, Rhode Island. You can reach out to his office (for appointments etc.) via phone at (401) 444-8467.

Mr Michael Clark is licensed to practice in Rhode Island (license number APRN01380) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1942653688.

Contact Information

Mr Michael Clark, NP
593 Eddy St, Apc Suite 523,
Providence, RI 02903-4923
(401) 444-8467
Not Available

Map and Direction




Provider's Profile

Full NameMr Michael Clark
GenderMale
SpecialityNurse Practitioner
Experience8 Years
Location593 Eddy St, Providence, Rhode Island
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mr Michael Clark graduated from nursing school in 2016
  NPI Data:
  • NPI Number: 1942653688
  • Provider Enumeration Date: 07/18/2016
  • Last Update Date: 11/24/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 5890066187
  • Enrollment ID: I20170804000947

Medical Identifiers

Medical identifiers for Mr Michael Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1942653688NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LC0200XNurse Practitioner - Critical Care Medicine APRN01380 (Rhode Island)Secondary
363L00000XNurse Practitioner APRN01380 (Rhode Island)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Brown Emergency Medicine7214833169140

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. Mr Michael Clark allows following entities to bill medicare on his behalf.
Entity NameBrown Emergency Medicine
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1962455022
PECOS PAC ID: 7214833169
Enrollment ID: O20040116000868
Entity NameLifespan Physician Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1407116643
PECOS PAC ID: 2567455082
Enrollment ID: O20121029000368
Entity NameRhode Island Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1154537520
PECOS PAC ID: 8921900044
Enrollment ID: O20141017000105

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. Mr Michael 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 AddressPractice Location Address
Mr Michael Clark, NP
593 Eddy St, Apc Suite 523,
Providence, RI 02903-4923

Ph: (401) 444-8467		Mr Michael Clark, NP
593 Eddy St, Apc Suite 523,
Providence, RI 02903-4923

Ph: (401) 444-8467

Reviews and Comments


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Mrs. Halina Kuc-mazgaj,
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Phina A Mayu, NP
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Phone: 401-274-6339    Fax: 401-453-6290
Beverly Casinelli, APRN
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Phone: 401-274-1122    Fax: 401-453-7571
Jennifer R Ouellette, MSN, RNP
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Phone: 401-273-7100    

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.