Mrs Kolu S Baysah Clark, DNP in Warwick, RI - Medicare Nurse Practitioner

Mrs Kolu S Baysah Clark, DNP is a medicare enrolled "Nurse Practitioner - Gerontology" in Warwick, Rhode Island. She graduated from nursing school in 2017 and has 7 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Umass Memorial Medical Group Inc and her current practice location is 455 Toll Gate Rd, Warwick, Rhode Island. You can reach out to her office (for appointments etc.) via phone at (401) 737-7010.

Mrs Kolu S Baysah Clark is licensed to practice in Rhode Island (license number APRN00086) 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 1336535624.

Contact Information

	Mrs Kolu S Baysah Clark, DNP
	455 Toll Gate Rd, Warwick, RI 02886-2759
	(401) 737-7010
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Kolu S Baysah Clark
Gender	Female
Speciality	Nurse Practitioner
Experience	7 Years
Location	455 Toll Gate Rd, Warwick, Rhode Island
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mrs Kolu S Baysah Clark graduated from nursing school in 2017

NPI Data:

NPI Number: 1336535624
Provider Enumeration Date: 04/13/2015
Last Update Date: 12/21/2021

Medicare PECOS Information:

PECOS PAC ID: 9335441237
Enrollment ID: I20210126003036

Medical Identifiers

Medical identifiers for Mrs Kolu S Baysah Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1336535624	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	RN2269378 (Massachusetts)	Secondary
363LP2300X	Nurse Practitioner - Primary Care	APRN00086 (Rhode Island)	Secondary
363LP2300X	Nurse Practitioner - Primary Care	RN2269378 (Massachusetts)	Secondary
363LG0600X	Nurse Practitioner - Gerontology	APRN00086 (Rhode Island)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Umass Memorial Medical Center/university Campus	Worcester, MA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Umass Memorial Medical Group Inc	4284539891	1898

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. Mrs Kolu S Baysah Clark allows following entities to bill medicare on her behalf.

Entity Name	Umass Memorial Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1760445373 PECOS PAC ID: 4284539891 Enrollment ID: O20040113000267

Entity Name	Evans Medical Foundation Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1912954124 PECOS PAC ID: 7416946546 Enrollment ID: O20040512000397

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. Mrs Kolu S Baysah 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
Mrs Kolu S Baysah Clark, DNP 455 Tollgate Rd, Professional Revenue Cycle And Credentialing, Warwick, RI 02886-2759 Ph: (401) 273-0641	Mrs Kolu S Baysah Clark, DNP 455 Toll Gate Rd, Warwick, RI 02886-2759 Ph: (401) 737-7010

Reviews and Comments

Nurse Practitioner Nurses in Warwick, RI

Mrs. Jennifer Jennings, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 455 Toll Gate Rd, Warwick, RI 02886 Phone: 401-737-7010 Fax: 401-736-1972
Sabrina O'donnell, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 455 Toll Gate Rd, Warwick, RI 02886 Phone: 401-737-7000
Amber Depaola, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 176 Toll Gate Rd Ste 103, Warwick, RI 02886 Phone: 401-921-5855
Jessica A Devine, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 171 Service Ave, Bldg 2, Floor 1, Warwick, RI 02886 Phone: 401-430-2000 Fax: 401-453-7597
Elena Pavlik Lvov, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3520 Post Rd, Warwick, RI 02886 Phone: 401-921-5800 Fax: 401-921-5826
Mr. Peter J Reilly, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 400 Bald Hill Rd, Suite 526, Warwick, RI 02886 Phone: 401-738-4323 Fax: 401-738-3857
Olajumoke Adetunji, DNP APRN FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 475 Kilvert St, Warwick, RI 02886 Phone: 401-737-6900

Mrs Kolu S Baysah Clark, DNP - Medicare Nurse Practitioner in Warwick, RI