Ms Myrlita Shawn Clark, NP,C in Philadelphia, PA

Ms Myrlita Shawn Clark, NP,C is a medicare enrolled "Nurse Practitioner - Gerontology" in Philadelphia, Pennsylvania. Her current practice location is 1999 W Hunting Park Ave, Philadelphia, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at (215) 228-9300.

Ms Myrlita Shawn Clark is licensed to practice in Pennsylvania (license number SPO10333) 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 1871729889.

Contact Information

	Ms Myrlita Shawn Clark, NP,C
	1999 W Hunting Park Ave, Philadelphia, PA 19140-2828
	(215) 228-9300
	(215) 228-9913

Map and Direction

Provider's Profile

Full Name	Ms Myrlita Shawn Clark
Gender	Female
Speciality	Nurse Practitioner - Gerontology
Location	1999 W Hunting Park Ave, Philadelphia, Pennsylvania
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1871729889
Provider Enumeration Date: 06/04/2009
Last Update Date: 04/19/2016

Medicare PECOS Information:

PECOS PAC ID: 3577619485
Enrollment ID: I20090917000607

Medical Identifiers

Medical identifiers for Ms Myrlita Shawn Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1871729889	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LG0600X	Nurse Practitioner - Gerontology	SPO10333 (Pennsylvania)	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. Ms Myrlita Shawn Clark allows following entities to bill medicare on her behalf.

Entity Name	Greater Philadelphia Health Action Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1205140902 PECOS PAC ID: 9537064977 Enrollment ID: O20110602000389

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. Ms Myrlita Shawn 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
Ms Myrlita Shawn Clark, NP,C 432 N 6th St, Philadelphia, PA 19123-4004 Ph: (215) 925-2400	Ms Myrlita Shawn Clark, NP,C 1999 W Hunting Park Ave, Philadelphia, PA 19140-2828 Ph: (215) 228-9300

Reviews and Comments

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Ms Myrlita Shawn Clark, NP,C - Medicare Nurse Practitioner in Philadelphia, PA